Wound care article for extraction and control of wound fluids

ABSTRACT

The subject of the invention is a wound care article for extraction and control of wound fluids, comprising at least one first fluid-absorbing structure ( 1; 10; 36 ), which is surrounded by a liquid-permeable, first enclosure ( 2 ),
     and a liquid-permeable, second enclosure ( 3 ) comprising two enclosing surfaces ( 13.1, 13.2 ). The wound care article is thus characterized in that the first enclosure ( 2 ) is covered or supported on at least one of its flat sides ( 4.1, 4.2 ) by at least one fluid-absorbing material layer ( 6.1, 6.2; 6.3 ), which is arranged (FIG.  1   a ) between the first enclosure ( 2 ) and one of the enclosing surfaces ( 13.1, 13.2 ) of the second enclosure ( 3 ).

The present application references the priority of Patent DE102006047041, whose published contents are fully respected here. Thepublished contents of Patent DE 102006047041 are included as an appendixto this application.

The invention concerns a pillow-shaped wound care article for theextraction and control of wound fluids according to the general terms ofclaim 1.

This type of wound care article is especially suitable for theextraction of exudate from chronic wounds, such as (for example) whendiabetes, ulcus cruris, and similar illnesses occur.

The term “exudate” designates a wound fluid that is secreted from theblood plasma through the inflammatory processes of the wound oedema.Just as the blood is responsible for the transportation of nutrients andother substances, and thus for supplying various parts of the body, theexudate serves in a very similar way to supply the wound bed and thehealing processes occurring therein. To perform adequately in thesevarious functions, it contains a broad spectrum of components, resultingin a specific density slightly greater than that of water. Thisdistinguishes it from “transsudate”, which is derived fromnon-inflammatory processes, and which has a significantly lower specificdensity with a lesser cell and protein content. In addition to providingnutrients for the fibroblasts and epithelial cells, the exudatecoordinates the various processes of local and chronological woundhealing, by means of its high concentration of growth factors andcytokines. These are formed primarily by thrombocytes, keratinocytes,macrophages, and fibroblasts. They influence the motility, migration,and proliferation of the various cells involved with healing the wound.Thus the migration of cells into the wound base is promoted, as well asthe supply for the newly created granulation tissue throughangiogenesis. Wound cleansing is also promoted by the exudate. Itcontains various serin, cystein, and aspartate proteases, as well asmatrix-metalloproteases, which by their strictly regulated activityremove irreversibly damaged tissue, and thus prepare the wound bed forsubsequent phases of healing.

Particular components of the physiological exudate are salts, glucose,cytokine and growth factors, plasma proteins, proteases (especiallymatrix-metalloproteases), granulocytes, and macrophages.

If a significant progression corresponding to the various phases of thewound healing process does not occur within a few weeks, it is called achronic wound. However, an exudative phase lasting even as long as threedays is regarded as a complication, and may be referred to as apathologic exudation, which may contribute to a chronic character of thewound. The fundamental underlying causes are usually complex and mayindeed be of systemic nature. In view of the previously mentionedimportance of the exudate for wound healing, it is not surprising, thatcomplications in healing of the wound will be reflected in significantlyaltered composition and the effects of the exudate.

The exudate, which normally promotes healing, will lose its positiveeffect for chronic wounds through (among other things) a shift inconcentration of the individual components of the exudate. Inparticular, the concentration of inflammatory cytokines and proteases issignificant increased in pathological exudates. Whereas, theconcentration of growth factors is reduced. A particularly importantdifference results in respect to the activity of thematrix-metalloproteases mentioned earlier. In addition to preparing thewound bed, they also take part later in rebuilding the granulationtissue to scar tissue. These enzymes are normally formed as inactivepre-enzymes, and their activity is regulated through correspondinginhibitors (tissue inhibitors of metalloproteases: TIMP's), which evenhave a simultaneous positive effect for cell growth. In chronic exudatethe activity of the proteases seems to be increased because ofdisturbances in this regulating system, which may contribute to anactive regression of the wound. With regard to the concentration of itscomponents, pathological exudate has gotten out of the balance requiredfor a progressive healing of the wound. The leads to variouscomplications, which contribute further to the deterioration and chroniccharacter of the wound.

A wound care article of the type mentioned above serves especially toabsorb this mentioned chronic exudate, and thus to promote healing ofthe wound. The applicant is aware of such a wound care article fromPatent DE 100 59 439. In the case of this familiar wound care article,the wound care article's additional, internal enclosure made of cottonhas the function to inhibit direct contact between the mucous cells ofthe patient's wound or body cavity and the absorbent pad. The effect ofthe wound care article applied on the patient's wound or bodycavity—especially the absorptive force acting on the wound—is the same,no matter whether its “left” or “right” side is used.

The purpose of the invention is to provide an appropriate wound carearticle, which permits greater flexibility in wound treatment for thecaretakers. An additional purpose is to make available an appropriatewound care article, which gives the caretakers the opportunity to reactdifferently, corresponding to the requirements of the wound to betreated. A further purpose to make available an appropriate wound carearticle, which is suitable on one side for application to weak tomoderately exuding wounds, and with the other side rather to strongexuding or secreting wounds.

These purposes are solved by a wound care article with thecharacteristics of the primary claim presented. The sub-claims designatepreferred construction forms. It must be noted that the area terms arealways to be understood as including the respective limiting values.

Hereafter a wound care article is envisioned, in which the firstenclosure is covered or supported on at least one of its flat surfacesby at least one fluid-absorbing material layer, which is arrangedbetween the first enclosure and one of the enclosing surfaces of thesecond enclosure.

The first enclosure can be surrounds by the second enclosure. In thisrespect it is preferably envisioned that the first fluid-absorbingstructure is surrounded by a likewise liquid-permeable internalenclosure consisting of two enclosing sheets. In this “enclosure inenclosure” construction form the fluid-absorbing material layer is thussurrounded only by the second, external enclosure, whereas the firstfluid-absorbing structure is surrounded by the external and the first,i.e. internal enclosure.

In what follows, the term “wound care article” shall designate inparticular a wound covering, preferably a flat wound covering or a woundcare cloth. Said wound covering may be designed to be both absorbing aswell as non-absorbing or only insignificantly absorbing. In particular,the term “wound care article” may also be understood as a collection ofvarious products, which are arranged in a specified position on thewound to be treated. This collection may form a physical unit, in thatthe various products are collected in a common enclosure, or—possiblywithout an enclosure—connected adhesively to one another. However, thecollection may also be present in form of a “kit”, in which the variousproducts are arranged with the aid of a compress in the specifiedarrangement on the wound to be treated.

In a different construction form, the first enclosure and the secondenclosure with the therein applied first structure and the materiallayer may form bandage booklet, in which both enclosures are foldable onat least one fold line or at least one long or spotted seam. The firstenclosure merges preferably as a single piece of material into thesecond enclosure.

The fluid-absorbing material layer is preferably a foam material pad,which may also contain cellulose fibres or particles. The material layermay contain hydraulic fibres and/or alginates. However, the materiallayer may also be made from other materials, as long as they have theability to absorb liquids.

The foam material mentioned is preferably polyurethane, for example,“cross-linked” foams.

In particular it is provided that the first fluid-absorbing structurecomprises a greater absorptive capacity and a higher extractive abilitythan the second fluid-absorbing structure, i.e. the aforementionedmaterial layer.

The term “pillow-shaped” should be understood in the following to be asubstantially flat structure, which primary consists of two side wallsthat form the exterior enclosure, whereby the side walls are connectedat their edges by adhesive, pressure, welded, or thermal connections,forming seams or borders. Since the exterior enclosure surrounds afluid-absorbing material layer (or pad), this configuration results in aflattened pillow form, which with increasing fluid absorptioncontinually achieved a more strongly curved cross section, especially onthat side of the wound care article on which the fluid-absorbingstructure is located.

The term “extraction and control of wound fluids” should be understoodin the following to mean that the wound care article according to thisinvention actively extracts and retains wound fluids. These wound fluidsare especially known pathologic exudates, which in principle may beemitted for as long as 48 to 72 hours. Moreover, this term implies thatboth absorbing structures are intended for use as wound care articles.

The first fluid-absorbing structure and the material layer may be equalin surface area, but preferably the structure of the wound care articleis such that the first fluid-absorbing structure is smaller in surfacearea than the material layer. This results in various possibilities forconstruction:

-   -   The enclosing surface of the second enclosure may simultaneously        form an enclosing surface of the first enclosure, whereby the        enclosing surface of the first enclosure can be attached to the        enclosing surface of the second enclosure by an encircling seam;    -   The first enclosure, composed of two enclosing sheets, may be        connected to the enclosing sheet of the second enclosure by an        encircling seam,        whereby in both cases is the condition applies that the first        enclosure is smaller in surface area than the second enclosure.

Furthermore, for the bandage booklet described above, the firstfluid-absorbing structure can likewise be smaller in surface area thanthe material layer.

The first fluid-absorbing structure is preferably a fleece-like pad.This may contain cellulose, especially carboxymethylcellulose, oralginate. The pad may also be woven in form.

Alginates are obtained from brown algae and are woven to form a fibrousfleece. Chemically these are polysaccharides, in fact calcium and/orsodium salts of alginic acids. Alginates can bind up to 20 times theirown weight of liquid, whereby the wound exudate is stored in the emptyspaces. The Ca²⁺ ions contained in the alginate lattice are exchangedfor the Na⁺ ions in the exudate, until the saturation level for Na-ionsin the alginate is reached. The wound care article thereby swells up andthe alginate fibres are turned into a gelatinous structure by theswelling of the fibres.

Carboxymethylcellulose is particularly present in form of sodiumcarboxymethylcellulose, and is marketed under the name of “Hydrofaser”,among others. In hygienic and wound products the fibres are deliveredinto a flat matrix. Through the extraction of liquid from the woundexudate, the fibres are gradually converted into a gelatinous pillow,which holds the liquid and does not release it again. For this thefibres are so structured, so that the wound exudate is extracted onlyvertically. This means that, as long as the capacity is sufficient, theexudate will not flow past the edge of the wound. By this method amaceration of the wound edge can be effectively prevented.

The pad-like absorbing structures manufactured in particular from sodiumcarboxymethylcellulose are very similar in their material properties,their methods of functioning, as well as in their indicative spectrumsto the alginate products. They are likewise applied in dry condition onthe wound, absorb wound exudate relatively strongly and quickly, and areconverted thereby into a translucent, cloudy gel. The capacity forabsorbing secretions is high, and (this) takes place in a verticaldirection. Thus the desired gel develops only in the region of the moistwound surface. The wound edge and the area surrounding the wound remaindry, no maceration develops.

The first fluid-absorbing and/or the material layer comprises preferablyof at least one super-absorbent substance. These are preferablySuper-Absorbing Polymers (SAP), which may be arranged in a matrixcontaining cellulose fibres. These preferably used super-absorbents areone reason that the first fluid-absorbing structure comprises a greaterextractive capacity and/or absorptive strength than a sodiumcarboxymethylcellulose, alginate, or foam pad.

Super-absorbing polymers (SAP) are plastics, which are able to absorbmany times their own weight—up to 1000 times—in liquid. Chemically,these are a copolymer of acrylic acid (propenoic acid, C₃H₄O₂) andsodium acrylate (sodium salt of acrylic acid, NaC₃H₃O₂), whereby therelative ratios of the two monomers may vary. In addition, a so-calledcore connecter (Core-Cross-Linker, CXL) is added to the monomersolution, which links the long-chain polymer molecules with chemicalbridges at various places to each other (“networking” them). Because ofthese bridges the polymer become insoluble in water. When water oraqueous salt solutions intrude in the polymer particles, they swell upand tighten this network at the molecular level, so that the water nolonger can escape without help.

The super-absorbent polymers may be present in the wound care articleaccording to the invention in the form of a granulate, a powder, acasting, a pressing, and/or a foam.

The super-absorbent particles may be present in powder or granulate formin a particle size between from 100 μm to about 1000 μm. The weightratio between the super-absorbents and the fluid-absorbing structurelies in the region from 0.01 to about 0.5.

The cellulose-containing pad forming the first fluid-absorbing structuremay be of “airlaid” type.

Furthermore, it is possible to manufacture the first fluid-absorbingstructure in the form of a casting, a pressing, and/or in the form ofshavings. The casting or the pressing may consist of either manyshavings manufactured from the padding, i.e. cuttings, or exclusively ofpowder, granulate, or thread-shaped super-absorbent particles. Theshavings themselves may also be loaded with super-absorbent particles.

The fluid-absorbing material layer may be arranged loose in of thesecond enclosure, or may be attached to the enclosure. The connectionmay be implemented by means of glue, welding, and/or by means of appliedpressure, they may be constructed over an area, or also in spot or inline form.

All pharmaceutically acceptable adhesives may be considered for theadhesive. In particular, polysaccharide-containing adhesives (such asstarch glue, for example), protein-containing adhesives, or acrylateglue, such as also find use as tissue glue, may be considered.Furthermore as the inventor has established, gels, or W/O (water inoil), or O/W (oil in water) emulsions may be used, to bind both padsadhesively to one another (i.e. adhesively in the above senses). Thewelding may be implemented for example through use of heat and/orultrasound, if needed in combination with pressure.

However, a construction of the wound care article is preferred, in whichboth the second fluid-absorbing material layer, and also the firstinternal enclosure, as well as the first fluid-absorbing structurepresent in the internal enclosure are freely movable.

In this arrangement the wound care article comprises two different sideswith differing levels of absorbing performance Depending on the level ofexudation, the caretakers can decide which side of the wound carearticle should be applied to the wound. For strongly exuding wounds, itis preferable to apply the side on which the first fluid-absorbingstructure with super-absorbent particles to the wound, whereas forweakly exuding wounds the side applied to the wound is that on which theaforementioned material layer is arranged, such as foam material or justa pad comprising sodium carboxymethylcellulose. Should the exudation ofthe wound in the latter case increase in the course of treatment,exudate from wound flows out of the reverse-side of the cellulose pad orout of the foam material and will be reliably extracted and bound thereby the strongly absorbent first fluid-absorbing structure withsuper-absorbent particles.

In addition to its high extractive capacity for exudates, a wound carearticle constructed in this manner has the property that it:

-   a) extracts and retains necrotic particles, pathogens, and    especially germs,-   b) extracts and retains exudates, but does not extract mucous, and-   c) results in a high atmospheric humidity due to the relatively high    vapour pressure, which contributes to the generation of a moist    environment that promotes wound healing.

The use of foam material or a hydro-fibre pad contributes to theprotection of the edge of the wound. Besides avoiding maceration, thepadding effect of the foam material is achieved. A desirable constanttemperature within the wound area can be sustained over an extended timeperiod, because the wound care article is relatively thick, and ensuresimproved thermal insulation.

However, it can also be provided that the material layer (the secondfluid-absorbing pad) is also provided with super-absorbent particles, toincrease its fluid absorption capacity.

The alginates mentioned are polysaccharides composed of 1,4 linkedα-L-guluronate and β-D-mannuronate. Alginates form homopolymeric areas,in which mannuronate or guluronate is present in (so-called) blocks.These blocks are called G or M blocks. In the region of the G-blocks andM-blocks a type of folder structure develops, which plays a substantialrole in gelling. In particular the G-blocks form a regular zigzagstructure.

In the form of fibrous calcium or calcium/sodium alginates, they arefamiliarly used as wound compresses or as wound tampons. Alginates havea large absorptive capacity and build a viscous gel that is stabile inform, by extraction of wound secretions and micro-organisms with strongswelling that keeps the wound moist (fluid absorption up to 20 times oftheir own weight). In addition, alginates act haemeostatically becauseof the release of calcium ions. The first fluid-absorbing structure mayalso be supported by a pad containing alginate, which likewise may alsobe arranged within the internal enclosure. In this construction form thepad containing alginate is preferably on the reverse-side of theparallel-aligned second material layer. Should the extractive capacityof the alginate pad be insufficient, the pad-like fluid-absorbingstructure will take up the extra wound exudate.

The second fluid-absorbing material layer may also be joined over itssurface to a pad containing alginate, which may lie between the secondfluid-absorbing material layer (pad) and the enclosing surface of theexternal, second enclosure.

The presence of the pad containing alginate on the side reversed fromthe first structure may be seen as advantageous by technical personnel,since it allows multiple selection possibilities for the use of anabsorbing structure with predetermined absorption capacity for a certainwound type and estimated exudate amount. In this case it isadvantageous, that the pad containing alginate has a smaller surfacethan the second fluid-absorbing material layer has, because an effectiveprotection for the wound edge must be considered.

The fluid-absorbing material layer may be perforated. This consistspreferably of relatively large holes of possibly varying geometry. Roundpores with a diameter of 2 mm to 15 mm may be provided. Furthermore, theperforated material layer may lie on an additional, preferablyperforation-free fluid-absorbing pad, preferably consisting of sodiumcarboxymethylcellulose or foam material.

The coarse particles of the wound exudate may attach to the pores. Theremaining thin liquid wound exudate reaches through the open-celled,hydrophilic foam structure into its depth. It may also be advantageousthat the perforated foam pad directed toward the enclosing surface haslarger pores than the other covering pad. In addition, it is alsoconceivable to use a so-called integral skin foam-as wound covering,which comprises of only a single foam layer, with a pore density thatcontinuously recedes, in this case beginning from the side near thewound, in the direction of the wound covering.

The internal and/or exterior enclosures are comprised preferably ofhydrophobic material, for example, of polypropylene, or from ahydrophobically treated natural material, such as cotton.

The hydrophobic characteristics of the enclosure (especially theexternal enclosure) prevent adhering to the wound surface and inaddition help the wound exudate particles to reach the inside of theenclosure more quickly.

Both enclosures may be manufactured from other plastic sheets,especially a polyurethane or polyethylene foil, or from artificialspider web sheeting.

The material of the internal and/or external enclosures may bestructured in such a manner that the enclosure comprises a roughinterior surface and a smooth exterior surface. The rough interiorsurface of the enclosure is preferably formed by funnel-shapedperforations, each of which narrows in the direction of the interiorsurface, and end in a freely opening edge (“open collar”). This roughinterior surface acts against shifts of the contents in the enclosure,so that an attachment with glue points is not necessary. Accordingly,the smooth exterior surface of the enclosing material may be formed bycurved material sections, extending between the perforations. Such anenclosing material may be called “three-dimensional”, in contrast to onethat is flat on both sides.

The exterior enclosure is preferably manufactured of such“three-dimensional” material, whereas the internal is preferablymanufactured from a “two-dimensional” material, i.e. a material that isflat on both sides. The adjective “flat” is understood here to be astructure of the enclosing material, in which the perforations and thematerial sections lying in between comprises no elevations. To increasethe friction between both enclosures still more, the material of theinternal enclosure may be rough. The perforations on both enclosures maybe different. In particular, the perforations of the external enclosuremay be larger than those of the internal enclosure, so that the thick(viscous) wound exudate and/or small cellular remains may travel intothe inside of the external enclosure. Whereas the thin liquid woundexudate comes through the internal enclosure, which can finally be takenup by the first pad.

However, construction of the internal and external enclosures both withsmooth or rough surfaces is also possible.

The wound care article according to the invention may be applied looselyon the wound or body cavity, and affixed over its entire surface to thepatient's body with a secondary bandage or a covering sheet.Accordingly, the wound care article may be part of an occlusive orsemi-occlusive system, or also a part of a compression or reducedpressure system.

The wound care article may be provided with its own attachment means,for example, in that the enclosing surfaces of the external enclosureare in each case provided with a peripheral adhesive strip on both ofits flat sides. The doubled adhesive strips make it possible to attachthe wound care article with the flat side selected by the technicalpersonnel to the patient's body. It is understood that medicallyharmless substances come into question as adhesives, in particular onesalready approved, for example, those based on polysaccharides. Tofacilitate the handling of the wound care article provided withperipheral adhesive strips, it is envisioned to provide in each caseboth of the opposing adhesive strips with a removable, for example,silicone-type protective strip.

The material layer of the described wound care article may comprise ofat least one central, window-like opening, in which an alginate insertfits, in particular calcium alginate, or also a bag with granulate orthread-shaped super-absorbent particles.

Because of the danger of maceration, pads of certain alginates may notreach beyond the wound edge. This requirement is countered by astructured framing of the alginate, which may consist both of sodiumcarboxymethylcellulose or also of foam material. The alginate insert canhave direct contact with the respective wound, in that a window isprovided in the enclosing surface of the external enclosure.

Metal ions, especially zinc, manganese, calcium, or silver ions may beadded to the components of the wound care article, especially to thepad, to support the local wound healing processes. Furthermore, honeyand its derivatives, enzymes, saponins, especially those of vegetablederivation (these are contained, for example, in Ribwort Plantain(Plantago lanceolata), or other disinfecting substances as well asvitamins, such as vitamin A, B₉, B₁₂, C, and E may be employed.Preferred are especially such components that have radical-capturing orantioxidant characteristics.

The foam material-pad may be open or closed-pore, hydrophilic orhydrophobic. If a closed-pore foam material is employed, it isrecommended to introduce continuous openings and/or holes in the foammaterial.

Additional advantages are achievable in combination with a foamconstruction within a common further, external enclosure. Two forms ofwound relief are achieved:

For strong exudation, the side of the wound care article is applied tothe wound, on which the first fluid-absorbing pad shows toward thesurface of the external enclosure, and by means of the desired strongabsorption effect, the wound care article relieves the wounded area, inthat it extracts the undesirable pathologic exudate, which comprisesharmful hormonal and component materials. Interstitial, intercellular,as well as cellular and also vascular spaces achieve close to aphysiological irrigation, so that perfusion, arterial influx, venousrecovery, and trans-membranous diffusion are optimized, and not by meansof long diffusion paths which are interfered with by pathologic aqueoussolutions and reactive bio-relevant enzymes. For cell growth requiresthe arterial influx of proteins, oxygen, as well as the contributionsfrom vessels, nerves, and functional supports of the immune defence.

In contrast with this realization, the existing therapeutic practiceemploys the application of bandages with comparatively low absorptivestrength and unsatisfactory retention. Often foam bandages are used,which under pressure release what little water has been extracted, alongwith components that interfere with wound healing. The focus thus driftsto surface of the wound and is occupied with treating resulting effectsand control of superficial cosmetic aspects.

It may thus be recommended to use foam material pad as the full-surfaceprimary contact layer, as long as the advantages of the pad interspersedwith super-absorbent particles find additional use. This may be achievedin that the foam has contact with the wound and the specified pad isapplied directly on its reverse, first to ensure the equalization to avery non-homogenous wound base morphology by means of a foam, which asflow-through and contact structure transfers the wound fluids directlyto the pad. It is also conceivable to fulfil this function by means ofalginates, carbon bandages, or cotton and fleece materials.

For weaker exudation, the foam side can be applied to the wound. Herethe wound care article achieves an indirect factor for wound relief, inthat it uses its absorptive strength to dry the back side of the foam.For this it is necessary that the foam is nearly soaked, so that thecurrent flow through the foam is achieved through (for example)capillary effects, and develops as a gentle inflow into thefluid-absorbing pad. Here the wound care article dries the back of thefoam and forms a secondary reservoir, which adds the capacity of the padto the capacity of the foam, even though it does not have significantcontact with the wound.

The wound care article according to the invention can be called amultiple-phase bandage, in particular a multiple-phase primary bandage,which permits an improved control of exuded wound fluid. The woundexudate flows into the foam and is “cached” there. The superfluous woundexudate is then absorbed by the internal absorbing structure, whichconsists of the pad containing cellulose and the internal enclosure.

When foams are used in the wound bandages, these tend to roll up attheir edges. The use of a “internal” absorbing structure formed by thepad and the internal enclosure on the reverse creates a desirablemechanical counter-force here, and contributes to retainingfull-surfaced contact with the wound area.

The principle of the individual wound care article according to theinvention makes it possible to carry out a simplified visual check ofthe emitted wound exudate with the use of absorbing structuresinterspersed with super-absorbent particles, provided that the absorbingstructure is employed in the form of set sizes adjusted corresponding tothe wound.

A great advantage is that the absorbed wound exudate can take and remainat a set position in the wound care article, so that the surroundingskin near the wound is not attacked by the wound exudate.

The wound care article according to the invention may be provided with astretchable covering sheet, which prevents the respective maximum volumeincrease of the wound care article during of the absorption process onlyminimally or not at all. Such a covering sheet may for example be laidwrinkled and/or pleated and/or folded and/or bellows-shaped. For thisthe existing application refers to the Applicant's PatentDE102007019622, whose published content should be fully included here.In particular, a wrinkled covering sheet may prove to be advantageous,since it is elastic in all directions. Should the folded or wrinkledcovering sheet extend past the periphery of the wound care article, itis recommended to thermally smoothen the surface extending beyond thewound care article.

The wound care article according to the invention can satisfy awound-filling function, if the alginate or foam-like material layer isgiven a spiral form with the assistance of a punching tool or anotherthermal and/or mechanical process. The alginate or foam-like materiallayer mentioned may also comprise multiple, concentrically applied roundor rectangular frames.

Preferably the frames are connected and arranged stepwise with oneanother by means of bridges consisting of the same material, so that thematerial layer punched to form multiple frames does not disintegratewhen unfolded.

In both cases, when applied to the wound the punched material layer mayprotrude at least partially as a “wick” from the second enclosure'senclosing surface toward the wound, when corresponding crossing cuts areworked into enclosing surface. The cuts should be implemented in such amanner, that the wick unfolding into the wound is not impeded by therectangular or triangular enclosing surface sections that develop. It isrecommended accordingly to place the cuts diagonally or radially on theenclosing surface towards the wound. When used, the wick imposespressure in the enclosing surface, whereby the enclosing surfacesections are shifted from their flat position, permitting the extensionof the wick. The first structure lying over of the wick supports theabsorption process.

As already mentioned, at least one of the enclosing surfaces of thesecond enclosure forms a common enclosing surface with a correspondingenclosing surface of the first enclosure. This construction isparticularly advantageous for a substantially smaller enclosing surfaceof the first enclosure, which is connected by means of an encirclingseam with the enclosing surface of the second enclosure. Thus in a topview of the enclosing surface of the second enclosure, two encircling,concentrically applied seams are present. For the swollen wound carearticle, the inner seam pulls together and prevents a spreading of thefirst structure, especially when a strong welling out is experienced bythe first absorbent structure. Such a construction of the wound carearticle is especially suitable for deep wounds.

The construction principle described also covers two full enclosures, ofwhich the first enclosure comprising two enclosing surfaces is attachedto the second enclosure comprising two enclosing surfaces by means of anencircling seam, whereby the first enclosure is smaller than the second.

Preferably it is envisioned that in addition, the wound care articlecomprises at least one nutritious, at least one disinfecting ordecontaminating, and/or at least one protease-limiting active substanceand/or compound of active substances.

The active substance and/or compound of active substances acting as adisinfectant may be (for example) a composition of at least one vitaminor vitamin derivative, a metal ion, as well as a detergent. It may alsobe a BUS (bacteriocin-like inhibitory substance) or a coated magneticparticle.

The active substance and/or compound of active substances workingnutritiously may be a composition containing at least the components ofan enteralen and/or parenteralen dietary substance. It may also be atleast one effective element selected from the group comprising insulin,recombinant insulin, proinsulin, an insulin-like growth factor (IGF), aninsulin replacement and/or a diabetic-specific, non-glucose andnon-saccharose-based energy source.

The active substance and/or compound of active substances affectingprotease limitation may be at least one effective element selected fromthe group comprising protease limiters, super-absorbent polymers,chelating agents for divalent cations, collagens, coated magneticparticles, acids, buffers, non-pathogenic acid-producingmicro-organisms, probiotics, and/or symbiotics.

Further connections and background about the nutritious, disinfecting ordecontaminating, and/or protease-limiting active substances and/orsubstance compositions are described in the Applicant's PatentDE102007030931 for the present application, whose contents arereferenced fully here. The Patent DE102007030931 describes additionalnutritive, disinfecting or decontaminating, and/or protease-limitingactive substances and/or compounds of active substances, which likewiseshould be treated as published for this application.

Furthermore, the wound care article according to the invention may alsobe employed in a wound maintenance system for wound drainage with use ofreduced pressure. Such systems are for example made known to theApplicant of the present invention in the Patents DE202004017052,WO2006048246, and DE202004018245, whose published content should beregarded as belonging to the present invention.

The first (patent) mentioned makes known a means for wound treatment byuse of reduced pressure, comprising a gas-tight wound covering element,which when applied to the patient's body forms an empty space betweenthe respective wound and the wound covering element, and at least oneconnection element, which stands in contact with the space, and by meansof which the air present in the space may be evacuated, whereby thewound covering element is underlaid by at least one wound care articlethat absorbs the wound secretions, whose volume increases in the courseof the absorption process, so that the absorbed wound secretions remainwithin the wound care article and thus underneath the wound coveringelement until the wound care article is removed from the body of thepatient, the wound care article comprises at least one layer of atextile section enriched with super-absorbent substances, which issurrounded by a liquid-permeable enclosure, and the layer has a surfacearea in top view of its flat side that is 3% to 90% smaller than that ofthe enclosure, so that when the wound care article is near its entirefilling capacity, it can approach a circular cross section.

The second (patent) mentioned makes known a multiple-component bandagefor wound treatment of human or animal bodies by use of reducedpressure, comprising:

a wound covering element for mounting on skin and mucous tissuesurfaces,at least one connection point, which stands in contact with the woundarea, and by means of which the materials present in the wound area canbe evacuated, whereby this comprises super-absorbent polymers, by meansof which the absorbed wound secretions remain bound to polymers in thewound area until these are removed from the wound area,whereby the polymers support reciprocal synergies with thesub-atmospheric pressure through their absorptive capacity.

The last (patent) mentioned makes known a means of drainage for woundtreatment by use of reduced pressure, comprising a gas-tight woundcovering element composed of foil-like material, which when applied tothe patient's body forms is fastened adhesively to the skin surfacearound the wound area, and which forms a sealed space remaining betweenrespective wound and the wound covering element, and at least onedrainage tube, which can be placed into the space, by means of whichmaterials present in the space can be evacuated, and at least one woundcare article applied within the space that absorbs the wound secretions,which comprises at least one layer of a textile section enriched withsuper-absorbent substance(s), which is surrounded by a liquid-permeableenclosure, so that the absorbed wound secretions remain within the woundcare article and thus underneath the wound covering element until thewound care article is removed from the body of the patient, and in whichthe wound covering element comprises a gas-tight, sealable opening forhandling, through which the wound care article may be laid in the spaceand removed from the space.

Moreover, the wound care article according to the invention maycomprises a form adjusted to anatomic conditions. For this it may, forexample, be constructed in form of a sleeve, which can be slipped overan arm or a leg or a joint, or in form of a bandage adapted to the heel,elbow joint, etc.

The wound care article according to the invention may in addition be soconstructed, that it is suitable for placement around a surgicallyimplanted tube. For this, the wound care article may comprise forexample at least one opening, which makes it possible to place thebandage around a cable on the body of a patient (for example a drainagetube or a catheter), whereby wound care article is associated with asecond, likewise surface-area wound care article, which lies at adistance from the first wound care article, whereby the distance isbridged by a connective strip or link. The Applicant of the presentinvention is familiar with such a wound care article, for example fromPatent DE202006005966, whose contents should be appended to thepublished content of the present description to their full extent.

In this connection it is also preferably envisioned, that the wound carearticle comprises at least one agent that can limit bleeding or thesusceptibility to bleeding.

The agent mentioned may be at least one chemically and/orphysiologically affecting active substance, or a compound of activesubstances, or at least one physically affecting effective element. TheApplicant of the present invention is familiar with such a wound carearticle, for example from the Patent DE102007036755.

For this, the wound care article for example may be:

-   -   constructed as a substantially flat material section comprising        absorbing material, composed of an absorbent fleece with        super-absorbent polymers, as well as at least one chemically        and/or physiologically affecting active substance or a compound        of active substances distributed therein,    -   a pressure or compression bandage, or in combination with        either,    -   a combination of a primary, non-absorbing or only        insignificantly absorbing wound covering, comprising at least        one chemically and/or physiologically affecting active substance        or a compound of active substances, and a secondary wound        covering applied peripherally to this primary wound covering,        which contains super-absorbent polymers, whereby a diffusion        barrier may be arranged between both,    -   in the form of a bandage package, comprising a primary wound        covering with at least one chemically and/or physiologically        affecting active substance or a compound of active substances,        as well as a wrapping section applied to the wound care article,        which comprises super-absorbent polymers at least in sections,        and/or    -   a material section with long extent comprising absorbing        material, whereby the material section comprises elastically        deformable characteristics, and whereby the material section        comprises super-absorbent polymers as well as perhaps at least        one chemically and/or physiologically affecting active substance        or a compound of active substances.

The chemically and/or physiologically affecting active substance orcompound of active substances is preferably at least one material or acomposition that comprises anti-haemorrhagic characteristics. Thesematerials are known by the general term “haemostatics”. The chemicallyand/or physiologically affecting active substance or compound of activesubstances is preferably at least one material or a composition thatcomprises anti-haemorrhagic characteristics. These materials are knownby the general term “haemostatics”. The term “chemically and/orphysiologically affecting active substance or a compound of activesubstances” should be understood in this context as such activesubstances or compounds of active substances, which are capable of limitbleeding or the susceptibility to bleeding, without requiring physicalforce to be used. The action path here is a chemical and/orphysiological interaction with the wound environment.

The physically affecting acting element is for example a binding, apressure pad, a pressure bandage, or a compression bandage. The term“physically affecting acting element” should thus be understood in thiscontext to be an effective element, which is capable of limiting thebleeding or susceptibility to bleeding by physical means, i.e. by theaction of pressure, suction, cooling, and other similar things.

The term “compound of active substances” should be understood in thefollowing not just as a compound in the chemical sense, but rather inparticular a composition of active substances that synergisticallyproduce an effect.

The active substances or compounds of active substances mentioned may bepresent as instant granules or powder.

Some example configurations of the wound care article according to theinvention are listed in the following table yet again:

First absorbent (Second) absorbent Enclosure structure pad configurationIllustration 1 “airlaid” pad with PU-foam material enclosure in (FIG. 9)super-absorbents, or CMC enclosure circular with or without super-peripheral absorbents, connection rectangular 2 “airlaid” pad in PU-foammaterial enclosure in FIG. 22 form of shavings or CMC enclosure FIG. 17with super- with or without super- or absorbents absorbents enclosureover enclosure 3 “airlaid” pad with PU-foam material with enclosure inFIG. 2 super-absorbents perforations enclosure 4 “airlaid” pad with CMCenclosure in FIG. 12, FIG. 13 super-absorbents with window, and anenclosure alginate insert there 5 “airlaid” pad with PU-foam materialenclosure over FIG. 17a super-absorbents (perhaps as shavings) enclosureor CMC 6 “airlaid” or PU-foam material bandage booklet FIG. 20, FIG. 21alginate pad or CMC with or without with or without super-super-absorbents absorbents 7 “airlaid” or PU-foam material enclosure inFIG. 25, FIG. 26, alginate pad punched (spiral or enclosure or FIG. 28with or without block form) enclosure over super-absorbents enclosure orbandage booklet 8 alginate pad with or PU-foam material enclosure inFIG. 27b without super- or CMC enclosure absorbents in cascading form(pyramid-shaped)

It is to be understood that in the scope of the present invention manyfurther combinations are possible.

The present invention will be described more precisely through showingand discussing the following figures and examples. It should beconsidered that the figures and examples merely have a descriptivecharacter and are not intended to limit the invention in any way. Theconstruction examples are described in detail by these figures. Thefigures show:

FIG. 1 a A wound care article according to the invention in its firstconstruction form, before sealing the enclosing surfaces, in a schematicexploded view;

FIG. 1 b The wound care article according to FIG. 1 a, ready for use, ina cutaway view perpendicular to the flat side of the wound care article;

FIG. 2 A second construction form of the wound care article, with meansof attachment, likewise in a cutaway view perpendicular to the flat sideof the wound care article;

FIG. 3 A third construction form of the wound care article, with astructural external enclosure;

FIG. 4 A fourth construction form of the wound care article, with astructural external enclosure and a foam material-pad appliedperipherally to the internal enclosure;

FIG. 5 A fifth construction form of the wound care article, with analginate layer laminated on the foam material;

FIG. 6 A sixth construction form of the wound care article, with adoubled pad within the first internal enclosure;

FIG. 7 The wound care article according to FIG. 1 b, in a top view ofits flat side;

FIG. 8 A section of the wound care article according to FIG. 1 b, in aperspective view;

FIG. 9 A seventh construction form of the wound care article, in a topview of its flat side;

FIG. 10 An eighth construction form of the wound care article, with acentrally applied alginate insert, in a top view of its flat side;

FIG. 11A cutaway view A-A according to FIG. 10;

FIG. 12 An arrangement of two foam material-pads and the alginate insertin an exploded perspective view;

FIG. 13 A ninth construction form of the wound care article, with analginate insert and a window, likewise in a top view of the flat side ofthe wound care article;

FIG. 14 Use of the wound care article according to FIG. 1 in areduced-pressure system, in a schematic view;

FIG. 15 Use of the wound care article according to FIG. 1 in anocclusive system, likewise in a schematic view;

FIG. 16 An eleventh construction form of the wound care article, in aperspective view;

FIG. 17 a A cutaway view B-B according to FIG. 16;

FIG. 17 b The swollen wound care article according to FIG. 16, likewisein a cutaway view;

FIG. 18 A twelfth construction form of the wound care article,represented as in the cutaway according to FIG. 17 a;

FIG. 19 A thirteenth construction form of the wound care article,likewise represented as in the cutaway according to FIG. 17 a;

FIG. 20 A fourteenth construction form of the wound care article, herein opened form, in a top view of its flat side;

FIG. 21 a The wound care article according to FIG. 20 during as it isfolded together; in a perspective view;

FIG. 21 b The wound care article folded together according to FIG. 21 a,in a schematic side view;

FIG. 22 A fifteenth construction form of the wound care article, in aschematic side view;

FIG. 23 A sixteenth construction form of the wound care article, withshavings in the internal enclosure, in a schematic side view;

FIG. 24 A seventeenth construction form of the wound care article, withshavings in an additional internal enclosure, in a schematic side view;

FIG. 25 a An eighteenth construction form of the wound care article,with a spirally-shaped, punched material layer containing alginate, in aschematic side view;

FIG. 25 b The wound care article according to FIG. 25 a in a top view ofthe side towards the wound;

FIG. 26 A nineteenth construction form of the wound care article, withan applied material layer comprising of multiple concentric, frame-likematerial cuttings, in a top view of the side towards the wound;

FIG. 27 a The wound care article according to FIG. 26, ready for use, ina schematic side view;

FIG. 27 b The wound care article according to FIG. 26 with deformedmaterial layer, in a schematic side view; and

FIG. 28 A twentieth construction form of the wound care article,likewise in a schematic side view.

In FIG. 1 a a first wound care article is represented designated withindicator 100, consisting of two external enclosing surfaces 13.1, 13.2,two internal enclosing surfaces 12.1, 12.2 and a first fluid-absorbingstructure 1 positioned between the internal enclosing surfaces 12.1,12.2. The said structure 1 exists in form of a cellulose-containing,fleece-like pad. The enclosing surface 12.1 is directed with its firstflat side 4.1 towards the exterior enclosing surface 13.1 and with itssecond flat side 4.2 towards a foam-like material layer 6.1 that liesbetween the internal enclosing surface 12.2 and the external enclosingsurface 13.2.

As especially shown in FIGS. 1 b, 7 and 8, the enclosing surfaces 12.1,12.2 surrounding the structure 1 as well as the external enclosingsurfaces 13.1, 13.2 are each sealed with one another by a peripheralultrasonic seam 28; 18 with a first internal and, correspondingly, asecond external enclosure 2; 3, so that the pad-like structure 1 iscompletely surrounded by the internal enclosure 2 and, correspondingly,the internal enclosure 2 as well as the foam-like material layer 6.1 bythe external enclosure 3. All enclosing surfaces 12.1, 12.2; 13.1, 13.2of the wound care article 100 are permeable to fluid. As material forthe manufacture of the enclosing surfaces 12.1, 12.2; 13.1, 13.2 aperforated polyurethane foil is used.

For the manufacture of the material layer 6.1 in the existing caseopen-celled polyurethane soft foam in a thickness between 2 mm and 3 mmis considered. The total thickness of the manufactured new wound carearticle 100 is about 5 to 6 mm. Both enclosures 2; 3 as well as thematerial layer 6.1 are not connected with one another. The pad-likestructure 1 lying within the internal enclosure 2 is arranged freelymovable in enclosure 2. The pad-like structure 1 contains a quantity ofgranular and powdery super-absorbent particles 5 (cf. FIG. 7).

Optionally, the second fluid-absorbing pad on the internal enclosure 2can be fixed by an adhesive point 14. FIG. 3 shows a wound care article400, where the enclosing surface 12.2 of the internal enclosure 2 isconnected with the material layer 6.3 made of sodiumcarboxymethylcellulose by means of the centrally applied adhesive point14. As sodium carboxymethylcellulose layer, for example, the materialknown under the trade name “HYDROFASER” is used (owner: E.R. Squibb &Sons, L.L.C., Princeton, N.J., USA). The surface area of the materiallayer 6.3 existing of sodium carboxymethylcellulose is larger than theinternal enclosure 2. The exterior enclosure 3 even is made of ahydrophobic material, here: polyurethane foil manufactured comprisingfunnel-shaped perforations 9 and curved material sections 11.1, . . .11.n, extending between the perforations 9, resulting in a roughinterior surface 7 on one side and in a smooth, wound-protectiveexterior surface 8 on the other side.

A wound care article 500 represented in FIG. 4 shows an exteriorenclosure 3 identical to the construction form according to FIG. 3. Theexterior enclosure 3 surrounds likewise the foam-like material layer 6.1and the internal enclosure 2 including the flat structure 1, however,the internal enclosure 2 and the foam-like material layer 6.1 areperipherally connected with one another by a welded seam 25.

The FIG. 5 shows a further wound care article (fifth construction form,reference symbol 600), that is a further development of the first woundcare article 100 represented in FIGS. 1 a, 1 b. Between the materiallayer 6.1, hereafter called foam material-pad, and the enclosing surface13.2 of the external enclosure 3 an alginate layer 15 is arranged with asomewhat smaller surface area than the foam material-pad 6.1.Alternatively, both layers 6.1 and 15 can have the same surface. Thealginate layer 15 is laminated on the foam material-pad 6.1 in the knownmanner.

A further development of the first wound care article 100 represented inFIGS. 1 a, 1 b is also shown in FIG. 6. In this case two pads are shown,evenly lying in the internal enclosure 2, one of those represents thefluid-absorbing structure 1 directed towards the material layer 6.1. Afurther pad 10 made of calcium alginate is laminated on the structure 1,both having the same surface area. The alginate-containing pad 10 is onthe reverse-side of the foam material-pad 6.1.

The FIG. 2 represents likewise a further development of the first woundcare article 100 represented in FIGS. 1 a, 1 b. A wound care articledesignated with reference symbol 200 is provided with fixation meanspermitting to fix the wound care article on the patient's body. For thispurpose, both enclosing surfaces 13.1, 13.2 of the external enclosure 3are provided in each case on their external surfaces with a peripheraladhesive strip 16.1, 16.2 as well as with a removable, protective strip17.1, 17.2 made of silicone paper. The foam material-pad 6.1 is providedwith multiple end-to-end openings 19 (holes) in a diameter of about 4mm. The advantage is that the two-sided provision of the fixation meansallows fixing the wound care article with any random flat side on thepatient's body.

The FIGS. 14 and 15 show schematically a use of the wound care article100 in a reduced pressure system 30 and, correspondingly, in anocclusive system 40. The reduced pressure system 30 contains a coveringsheet 31 impermeable to fluid and water vapour and a vacuum channel 29following the covering sheet 31 through a schematically shown opening33, being preferably positioned in parallel to the wound care article100. The wound care article 100 comprises again an alginate-containingmaterial layer 6.3 directed towards the wound 35, with a smaller surfacearea than the pad-like structure 1 lying within the internal enclosure2. The fluid-absorbing structure 1 consists of fleece-like appliedcellulose fibres and super-absorbent particles 5 distributed therein.The covering sheet 31 is not connected with the enclosing surface of theexternal enclosure 3.

The occlusive system 40 contains a liquid-tight, but water vapourpermeable covering sheet 32 and the said wound care article 100,likewise comprising the alginate-containing material layer 6.3 directedtowards the wound 35, having a smaller surface area than the structure 1lying within the internal enclosure 2.

Both flexible covering sheets 31, 32 protrude the periphery 38 of thewound care article and are each provided with a peripheral adhesivesurface 39 so that they can be fixed without any problems on the skinaround the wound.

The covering sheet 32 shown in FIG. 15 is pleated (folded) so that itsoverall surface area is larger compared to a smooth sheet. This isadvantageous and allows a wide extension of the covering sheet 32 duringof the process of absorbing so that a considerable increase in volume ofthe wound care article will not lead to substantial counteracting forcescaused by the covering sheet. The indicator 41 designates the schematicpleats in the covering sheet 32. In a not represented sample ofconstruction the covering sheet is not pleated, but wrinkled. Thecrepe-like covering sheet can extend in all directions.

A round wound care article 300 is shown in FIG. 9. However, only theexterior enclosure 3 and the foam material-pad 6.1 are round, on theother hand the internal enclosure 2 as well as the pad-like structure 1are square in the top view to the flat side of the wound care article300, whereby the extents of the internal enclosure 2 are adapted to theinterior of the external enclosure 3 in such a way that the internalenclosure 2 with all its four corners 21 is almost reaching theultrasonic seam 18. This method excludes the undesirable shifts of theinternal enclosure within of the external enclosure by simple means,without the use of adhesive (possibly not desired for medical reasons).Such a configuration can be realized very easily. As shown in FIG. 9,the pad-like structure 1 is smaller in surface area than internalenclosure 2 so that unfolding within enclosure 2 is fully possibleduring absorption. A distance designated with reference symbol A betweenthe ultrasonic seam 18 of the internal enclosure 2 and an exterior edge26 of the structure 1 can be variable at the periphery, when the statedextents of the structure 1 and the internal enclosure 2 will be kept.

The FIGS. 10 and 11 represent a wound care article 800 consisting of theinternal enclosure 2 with therein included fleece-like structure 1, ofthe external enclosure 3 and two superimposed foam material-pads 6.1,6.2, whereby a rectangular, centrally applied opening 20 is punched outof the foam material-pad 6.2 directed towards enclosing surface 13.2 sothat a framing 22 (cf. in particular FIG. 12) for an alginate insert 23being positioned in the opening 20 is obtained.

The FIG. 13 shows a similar wound care article 900, where a window 24 ispunched out of the enclosing surface 13.2 of the external enclosure 3,whose edges 27 slightly overlap the alginate-containing insert 23. Bythis way, sufficient support for the insert 23 is ensured within theopening 22. The alginate-containing insert 23 can come into directcontact with the respective wound. Optionally, super-absorbent substancein form of powder, granulate or fibres can be inserted in thealginate-containing insert 23.

The FIGS. 16, 17 a and 17 b show a wound care article 1000, where thesubstantially smaller enclosing surface 12.1 of the first enclosure 2 isconnected with the enclosing surface 13.1 of the second enclosure 3 by acirculating ultrasonic seam 37. This is done without a second enclosingsurface 12.2 of the first enclosure 2. The smaller enclosure 2 with around outline 34 is arranged centrally on the second enclosure 3. Withinthe second enclosure 3 the foam-like (polyurethane foam) material layer6.1 and, correspondingly, within the first enclosure 2, acellulose-containing pad (structure 1) is arranged moveably. The larger,in the present case square enclosure 3 has dimensions of 10×10 cm, andthe smaller has a diameter of about 6 cm, in each case measured up tothe corresponding ultrasonic seam. Based upon these dimensions of bothenclosures 2; 3, the material layer 6.1 amounts to about 6.5 cm×6.5 cm,and the pad-like structure 1, however, has a diameter of about 4 cm.

The wound care article 1000 after an absorption process represented inFIG. 17 b shows a moderately swollen foam material-pad 6.1 and astrongly swollen, almost hemispheric structure 1. This configuration ofthe swollen wound care article with a one-sided convex surface canadjust to the surface properties of a deep wound, fill it up, and thusaccelerate the healing process. Moreover, due to the convex surface apermanent contact between absorbing materials and the wound base isensured, thus assuring a permanent exudate uptake. These advantages arealso valid for all other arrangements having a convex surface and/orpermitting a wound filling.

Instead of structure 1 made of a cellulose-containing pad withsuper-absorbent particles 5 distributed therein, other highly absorbingmaterials, such as an alginate-pad, a casting of shavings and/or ofsuper-absorbent particles can be used. FIG. 19 shows a wound carearticle 1200, whose structure is very similar to that of the wound carearticle 1000, whereby the smaller enclosure 2 contains a casting ofshavings 36. The shavings 36 of average sizes from 3 mm to 5 mm areautomatically cut out of a cellulose-like, multi-layered airlaid pad,fortified with super-absorbent particles. Tests have shown that acasting of shavings 36 having the same weight than an entire pad canabsorb the same amount of fluid about 15% faster. The reason mightprobably be the increased surface of the shavings' construction form incomparison to an airlaid-pad of the same weight.

A particular advantage is that the shavings 36 can also be made out ofthe waste products from pad production.

This construction also offers the advantage that in contrast to a flatpad—the shavings can extend three dimensionally when swelling, thusforming a convex surface, similar to a casting, and, for example, canfill up wound cavities.

This characteristic reveals a healing accelerating effect. Due to thewound cavity filling, a permanent contact between absorbing materialsand the wound base is ensured, which guarantees a permanent exudateuptake. These advantages are also valid for all other arrangementshaving a convex surface and/or permitting a wound filling.

In a further construction sample (not represented), likewise referringto the wound care article 1000, the smaller enclosure 2 has its bothenclosing surfaces 12.1, 12.2. Therefore, the entire smaller enclosure 2is applied to the second larger enclosure 3 and peripherally connectedwith the latter.

The FIG. 18 shows a wound care article 1100, whereby the first smallerenclosure 2 with its enclosing surface 12.2 directed towards materiallayer 6.1 is applied to enclosing surface 13.1 directed to the reverseside of the material layer of the second enclosure 3 by means of aperipheral ultrasonic seam 37. The function of the second, not existingenclosing surface 12.1 of the first enclosure 2 is taken over by theenclosing surface 13.1 of the second larger enclosure 3. Apart fromthat, the wound care article 1100 consists of the same parts mentionedin the description of the wound care article 1000 (FIGS. 16, 17 a and 17b).

One of the wound care article 1300 represented in the FIGS. 20, 21 a and21 b is a bandage booklet 42 (cf. FIG. 21 a), resulting from folding uptwo wings 43.1, 43.2 of a common double covering 44 along a fold line X.FIG. 20 shows that the folded-up double covering 44 consists of thefirst enclosure 2 and the second enclosure 3, whereby the firstenclosure 2 passes as one piece of material into the second enclosure 3.The wings 43.1, 43.2 are each made up of enclosure 2 or 3 and thecorresponding absorbent materials. In the existing construction samplethe first enclosure 2 contains a highly absorbing textile material, inthis case the already mentioned pad-like structure 1, and the secondenclosure 3 the likewise described foam-like material layer 6.1. Twospot joints 55.1, 55.2 are positioned along the fold line X separatingthe two enclosures 2; 3 having the same surface area in such a way thatthe absorbent materials within the double covering 44 cannot be shiftedover the fold line. The fold line X can be replaced by a notrepresented, continuous seam; however, it can also be perforated toallow a separation of both halves by tearing them apart.

A wound care article 1400 represented in FIG. 22 shows an“enclosure-in-enclosure”-configuration that is also shown in FIG. 1 b,for example. The difference between both wound care articles 100 and1400 is that the first internal enclosure 2 of the wound care article1400 contains the already described shavings 36 cut out of theairlaid-pad and that the material layer 6.3 lying outside of theinternal enclosure 2 consists of hydraulic fibres, i.e. of sodiumcarboxymethylcellulose, whereby the material layer 6.3 has a largersurface area than the internal enclosure 2.

The FIG. 23 shows again a wound care article 1500 consisting of thefoam-like material layer 6.1 in the second external enclosure 3, thefluid-absorbing pad-like structure 1 in the first internal enclosure 2,and a casting of shavings 36, which are arranged in an additionalinternal enclosure 45 directed to the reverse-side of enclosure 2. Bothinternal enclosures 2, 45 are thus lying each between the material layer6.1 and an enclosing surface 13.1, 13.2 of the external enclosure 3.

The FIG. 24 represents a wound care article 1600 showing an airlaid-pad(structure 1) positioned in the internal enclosure 2 and an additionalinternal enclosure 46, where a casting of alginate cubes or shavings 47is located, and both internal enclosures 2 and 46 are surrounded by theexternal enclosure 3. The alginate cubes or shavings 47 can be replacedby hydrofibre shavings (not represented).

The FIGS. 25 a and 25 b show a wound care article 1700 of similarmaterial than the wound care article 100. The internal enclosure 2covers the structure 1 made of an airlaid-pad, whereby the exteriorenclosure 3 comprises the internal enclosure 2 with the structure 1 aswell as the foam-like material layer 6.1 (polyurethane soft foam),which, however, is spirally punched, as shown FIG. 25 b. On theenclosing surface 13.2 of the external enclosure 3 there are twocrossing, diagonally arranged cuts 47.1, 47.2, dividing this enclosingsurface in four triangular enclosing surface areas 48.1, 48.2, 48.3,48.4, which will slightly differ from their original flat position whenbeing used (cf. FIG. 25 a) due to the gravity acting upon thespiral-shaped material layer 6.1 and thus allowing the penetration of apart of the spiral-shaped material layer 6.1 at least or of a wick 49developed of the latter in direction towards the wound. The describedwound care article 1700 thus fulfils a wick function in case of deepwounds, whereby the structure 1 above the wick 49 supports the absorbingprocess. In addition, there is a wound filling and healing acceleratingeffect. Due to the filling up of the wound, a permanent contact betweenabsorbing materials and the wound base is ensured which guarantees apermanent exudate uptake. These advantages are also valid for all otherarrangements having a convex surface and/or permitting a wound filling.

Instead of the diagonally arranged cuts 47.1, 47.2 punchings, orperforations, or markings along the drawn lines can be provided. Thecaretakers can cut along the lines, whereas in case of punchings orperforations the said cuts can be made by tearing.

The FIG. 25 c shows a similar wound care article 1700, where a window 56is provided in the enclosure on the side of enclosure 3 which isdirected towards the wound, whereby the dimensions of the window aresmaller than those of the material layer 6.1 provided in the externalenclosure. The latter consists of spiral-shaped punched foam pad andremains in dry condition within the enclosure. Only in case of contactwith liquids, especially with exudate, a part of the spiral-shapedmaterial layer 6.1 at least or a wick 49 developed of the latter willpenetrate the enclosure in direction towards the wound.

The FIGS. 26, 27 a and 27 b show a further wound care article (indicator1800) with a likewise punched, foam-like material layer 6.1, however,being totally surrounded by the external enclosure 3 together with thepad-like structure 1 lying within the first enclosure 2.

On the rectangular material layer 6.1 multiple concentrically arrangedand likewise rectangular frames 50 are punched out by means of apunching tool with bridges 51, 52 connecting the frames 50. In case ofapplication (cf. FIG. 27 b) the punched material layer 6.1 deforms to asignificantly three-dimensional suction structure 53, which can adaptitself to the respective wound, if a correct size of type of the woundcare article has been selected. Because the bridges 51, 52 are arrangedon the material layer 6.1, the suction structure 53 does notdisintegrate. Condition for the correct function of the described“Zoom-bandage” is a sufficiently extendable enclosure. If also fourdeformable triangular enclosing surface parts 48.1, 48.2, 48.3, 48.4have been provided by cuts (cf. FIGS. 25 a, 25 b) on the enclosingsurface 13.2 of the external enclosure 3, a wound care article 1900 asrepresented in FIG. 28 will exist. When the latter is applied on to thedeep wound, the frames 50 being connected with one another throughbridges will penetrate the enclosing surface 13.2. The smallest frame 50is connected with a central material section 54 by the bridge 51 beingthe deepest. The wound care article 1900 is a combination of the woundcare articles 1700 and 1800.

Not represented in FIGS. 25-28, but corresponding to the here describedprinciple is a construction form, where the exterior enclosure alreadyhas a window, i.e. a cut-out, allowing to look upon the foam-likematerial layer underneath, punched as above described, and thus allowingthe penetration of a part of the foam-like material layer 6.1 at leastor of a wick 49 developed of the latter in direction towards the wound.

The FIG. 27 b shows a further wound care article (indicator 1800) in analternative arrangement, whereby multiple layers of a not punchedfoam-like material layer 6.1 of different sizes are arranged above eachother in cascaded or pyramidal form and are completely surrounded by theexternal enclosure 3 together with the pad-like structure 1 lying in thefirst enclosure 2.

This configuration can correspond to the surface property of a deepwound, fill it up, and thus accelerate the healing process. Furthermore,due to this arrangement a permanent contact between absorbing materialsand the wound base is ensured, thus assuring a permanent exudate uptake.

REFERENCE-NUMBER LIST

-   1 fluid absorbing structure-   2 enclosure-   3 enclosure-   4.1, 4.2 flat side-   5 super-absorbent particles-   6.1 to 6.4 material layer-   7 interior surface-   8 exterior surface-   9 perforations-   10 pad-   11.n material field-   12.1, 12.2 enclosing sheet-   13.1, 13.2 enclosing sheet-   14 adhesive point-   15 alginate layer-   16.1, 16.2 adhesive strips-   17.1, 17.2 protective strip-   18 ultrasonic seal-   19 opening-   20 opening (v. 6.2)-   21 corner-   22 frame-   23 insert-   24 window (v. 13.2)-   25 welded seam-   26 exterior edge-   27 edge-   28 ultrasonic seal-   29 vacuum tube-   30 reduced pressure system-   31 covering sheet-   32 covering sheet-   33 opening-   34 outline-   35 wound-   36 shavings-   37 ultra-welded seam-   38 periphery-   39 adhesive surface-   40 occlusive system-   41 folds-   42 bandage booklet-   43.1, 43.2 wing-   44 double covering-   45 additional enclosure-   46 additional enclosure-   47.1, 47.2 cut-   48.1, 48.2 enclosing surface section-   48.3, 48.4 enclosing surface section-   49 wick-   50 frame-   51, 52 bridge-   53 three-dimensional absorbing structure-   54 material section-   55.1, 55.2 spot joint-   A distance-   X fold line-   100; 200; 300 wound care article-   400; 500; 600 wound care article-   700; 800; 900 wound care article-   1000; 1100 wound care article-   1200; 1300 wound care article-   1400; 1500 wound care article-   1600; 1700 wound care article-   1800; 1900 wound care article

APPENDIX 1 Published Content of Patent DE 102006047041 (PriorityApplication) Surface Area Absorbing Structure

The invention concerns a surface-area absorbing structure forapplication to human as well as to animal body surfaces, especially forextraction and control of wound fluids, such as pathological woundexudate from the depth of the wound base; this wound exudate causes theformation of humidity present in the wound region, due to evaporationprocesses of the aqueous portions of the extracted exudate; comprising:

-   -   at least one fluid-absorbing pad with a uniform coloured        surface,    -   a quantity of super-absorbent particles, which are distributed        on or in the pad, and which accelerate absorption of wound        exudate,    -   and at least one liquid-permeable enclosure surrounding the pad,        comprising two surfaces,    -   whereby the super-absorbent particles are essentially white or        naturally coloured.

An absorbing structure of the type mentioned initially is known from thepublication “Wund Forum” by the company Paul Hartmann AG, 4/95. Theabsorbing structure represents a pillow-shaped wound covering employablefor wet therapy, or a rinsing structure. The known absorbing structureis activated with a quantity of electrolytic solution, such as Ringer'ssaline solution, and applied to the wound. Through absorption of theRinger's saline solution, the absorbing structure swells up. It has nowbeen shown that a significant part of the existing absorbing power ofthe absorbing structure is lost through the use of Ringer's salinesolution. In addition the healthy skin areas bordering the wound maytend to inflammatory oedema because of the permanent wetness, since apre-saturation and a weakening of the absorptive performance occursthrough filling with aqueous media and especially with its electrolytes.

The purpose of the invention is to extend the use areas for woundhealing of the absorbing structure of the type initially mentioned, inparticular for strongly secreting, infected wounds, from which the woundexudate may be extracted more effectively from the depth of the woundbase, whereby a visual check of the emitted wound fluids standsprominent.

This purpose is solved by a corresponding type of absorbing structure,for which

-   -   after application to the wound and direct moistening with the        wound fluid, the pad marks the respective wound areas and the        exterior contour of the wound in colour through the retention of        the pad's originally-coloured surface areas, whereby the pad        reaches past the respective wound edge in the applied condition        of the absorbing structure, and covers healthy skin areas all        around the wound,    -   the pad changes in thickness in such a manner, in that the        thickness increases proportionally corresponding to the local        absorption conditions, through osmotic or atmospheric pressure        conditions, whereas the original thickness of the pad remains        unchanged for the mentioned adjoining surface areas.

The absorbing structure is essentially applicable on the respectivewound surface in a dry condition that is not influenced by foreign,non-bodily liquids.

In the present case, the adjective “dry” designates the condition inwhich the absorbing structure comes to be used, as it is removed fromthe package under normal ambient conditions. These normal ambientconditions can correspond to the especially for human medicinerecommended room temperature, and a relative humidity of the ambient airfrom 45% to 55%, whereby deviations from these values within broadlimits are possible, for example, up to 90% for relative humidity.

In contrast to the known types of moist therapy, the absorbing structureaccording to the invention can be used without being wet. Here as wellit can be used as covering, as a wound covering, or as a bandage.

The absorbing structure should be used for the extraction and control ofwound fluids, such as pathological wound exudate from the depth of thewound base, so that the formation of humidity develops in the woundregion, due to evaporation processes of the aqueous portions of theextracted exudate.

The absorbing structure according to the invention should find use foracute and chronic wounds, iatrogenically separated locations of theskin, burn wounds, inflammatory moistening processes of the skin, orulcerating processes of neoplastic origin, moistening infections,fistulae, post-operative drainages, stomata, atopisch variable areas ofthe skin, refolding skin wrinkles near joints such as armpit or groinskin, mucous tissue surfaces in humans and in animals, as well as incombination with other bandage materials that have locally therapeuticeffects, and for other applications, for which an atraumatic woundcovering is indicated. Split skin removal locations, plastic coverings,abscesses, and urologic applications may be likewise noted asindications, as also proctologic applications and prophylactic use forprevention, for example, for containment of germ spreading and reductionof the transfer of germs. In particular, the functional combination withother broadly described advantages are prominent here. Applicationsunder reduced atmospheric pressure, whether continuous or periodicallycontrolled, electrically or manually, applications for compressiontherapy, or carbon dioxide baths form substantial approaches here.

Essentially two cleansing processes act upon the wound. First, thesuper-absorbent particles withdraw the wound exudate from the base ofthe wound, in which a normal physiological hydration is supported. Thewound edges are stabilized and a desirable wound bed conditioning alsotakes place. Secondly, fewer aqueous waste products are concentrated infront of the enclosure, which adhere onto the enclosing material and areremoved by exchanging the used absorbing structure. The absorbingstructure according to the invention acts against a superfluousgranulation of the wound. Since the pathological exudate is extracted,harmful proteases are extracted, which include, for example, MMP's(Matrix Metallo Proteases) and TIMP's (Tissue Inhibiting MetalloProteases). Because of the active absorption processes of the harmfulproteases, a secondary anti-inflammatory performance is achieved. Theabsorbing structure adjusts itself by means of the absorption andswelling process to the morphology of the wound region.

The pad locally impregnated with the wound fluid fills up the respectivewound at least partially.

The pad may be freely movable within the enclosure.

Ideally, the swollen absorbing structure should be applied over itsentire surface to the wound area. In this connection the enclosingsurface away from the wound may comprise a textile or sheet materialwhich is not or only slightly elastic, whereas the other surface nearthe wound is substantially more elastic.

It is desirable to have a surface area as large as possible for thesuper-absorbent particles distributed in the adhesive-free core, as wellas the greatest possible homogeneity of the core. The super-absorbentparticles embedded in the core may form essentially a uniform matrix.The super-absorbent particles may be sharp-edged, so that their surfacearea may be increased in comparison to spheres. The sharp-edgedsuper-absorbent particles simultaneously improve the adherence to thetextile fibres, which are preferably processed into a random ordirectionally oriented, mechanically solidified fleece. The textilefibres may be creased, bent, or folded fibre sections of various widthsand lengths. The textile fibres may be placed at least partially aroundthe individual super-absorbent particles, so that the bordering areasand thus the absorptive strength may be increased.

The super-absorbent particles may be of polymeric nature, for example,they may be present as networked, partially neutralized acrylic acidpolymers. The super-absorbent particles may also be gelatinous orceramic.

The super-absorbent particles may be added to a core network, present asCore-Cross-Linker (CXL), or also as Surface-Cross-Linker (SXL), or amixture of both.

The absorbing structure may be designated as a hydro-active woundbandage, which permits the extracted liquid to evaporate again.

The employment possibilities for the absorbing structure may be extendedby the addition of pharmacological materials of atomic or elementarybasis, such as compounds of Zn, Ca, and Na. The pharmacologicalmaterials include for example: anti-inflammatories, antibiotics, growthfactors, homeopathics, analgesics, antipyretics, and disinfectants.

The pad present in the enclosure or enclosure may be supplied withextracts of brown algae, carboxymethylcellulose, alginates, hydraulicfibres, hydro-capillaries, hydraulic gels, enzymes, compounds on thebasis of ceramics, growth factors, metallic additives, for example, onthe basis of silver, gold, platinum, and titanium, furthermoreosmotically active substances, such as salts, sugar, proteins, orenzymes such as peroxidase for the regulation of osmotic pressure. Theaddition of germ-count reducing materials such as Octenidin orPolyhexamide may also be envisioned.

The reduction in the germ count by means of the physical characteristicsof the bandage materials (reduces) the danger of mutations, biofilms,resistance, and infections, and improves the effectiveness of antibioticmeasures through pharmacological treatments.

The pharmacological materials may be extracted and dissolved by thebody's own liquids, such as by pathological wound exudate, without theuse of electrolytic solutions.

For example, an effect upon sub-surface exudate pointing in thedirection of the absorbing structure is achieved, changing the deliveryof the emitted amount as well as the speed of the delivery. Thepathologic tendency for particularly slow flow of wound fluids throughthe tissue, which can lead to a stasis of the wound fluid in the tissuedepth, leads to cellular oedema and over-hydration of the cellularinterstices, so that by means of the suction to be performed here on theexternal exudate the stasis is shifted towards a flow of the liquid tothe absorbing structure. The over-hydration of the wound base depth isthus reduced, and its overall nutritive condition and thus its potentialfor healing is improved.

Essentially two cleansing processes act upon the wound. First, thesuper-absorbent particles withdraw the wound exudate from the base ofthe wound, in which a normal physiological hydration is supported. Thewound edges are stabilized and a desirable wound bed conditioning alsotakes place. Secondly, fewer aqueous waste products are concentrated infront of the enclosure, which adhere onto the enclosing material and areremoved by exchanging the used absorbing structure. The absorbingstructure according to the invention acts against a superfluousgranulation of the wound. Since the pathological exudate is extracted,harmful proteases are extracted, which include, for example, MMP's(Matrix Metallo Proteases) and TIMP's (Tissue Inhibiting MetalloProteases). Because of the active absorption processes of the harmfulproteases, a secondary anti-inflammatory performance is achieved. Theabsorbing structure adjusts itself by means of the absorption andswelling process to the morphology of the wound region.

By means of the absorption process, the absorbing structure may becomeso heavy that it slows the superfluous granulation by means of its ownweight, and thus assists with the homogenization of the wound bed. Theweight-determining element is the wound exudate itself.

Thus a bandage material is produced that to a superficial view has ahomogenous surface, but because of its technical design offers a generalwound-phase-specific solution.

Where a wound is necrotic, the bandage material scrubs it and rubs itaway, whereby the subsequent wetting is captured by (the bandagematerial).

Where a wound is infected, there (the bandage material) extracts thegerms, and withdraws germs, toxins, exudate, sources of inflammation,and oedema from the wound. Since the oedema and products of theinflammatory reaction support the creation of organized germ systems(called “biofilm”), this absorbing structure shortens the duration ofthe infection, it reduces the probability of occurrence for infection,assists synergistically with additional anti-infective measures, reducesthe development or the probability of occurrence of biofilms, and thusforms an effective treatment option for germs such as MRSA (methicillinresistant staphylococcus aureus). In particular, the elimination ofthese population-endangering germs reflects strongly on the quickhealing of chronic wounds for physicians in ambulant, home-bound,non-hospitalized situations, since they experience these pathogenicconditions here and may lead to possibly life-endangering, oftenunmanageable infections. This is also true especially for germs such asVRE (Vancomycin-Resistant Enterococci) and CA-MRSA (Community AssociatedMRSA).

Where a wound is in the cleansing phase, (the bandage material) activelyextracts the rinsed out liquids and binds them.

Where a wound granulates and forms new cells, (the bandage material)protects them from the compounds of the pathological exudate of theneighbouring wound areas.

Where a wound is hyper-granulated, (the bandage material) retards it tothe desired growth speed by its own weight and the weight of theextracted exudates.

Where a wound stops and the wound edge is located, (the bandagematerial) keeps the wound region free from the inflammatory oedematousprocesses of healthy skin.

Even where healthy tissue is located, the minimal thickness of (thebandage material) under compression bandages also assists in that thetransitional edge of the bandage does not press very deeply into thepatient's skin, whereas many other products are rather thick and promoteline markings, impressions, or lasting pressure edges with the danger ofreducing perfusion and thus resulting in skin damage.

Its minimal thickness transfers compressive force from surroundingcompression bandages as well as possible, whereas according to LaPlace's law thicker bandages with the same compressive environment andthus with larger radius interfere with the compression into the depth towhere it should be transferred, and transfer less or even uncontrollablyless compression. This is particularly the case with foam bandages andthick cellulose layers, since they make this reduction here even worseby their elasticity.

The enclosure has various functions. Even though a technically not verydemanding PP non-woven may be selected, it fulfils many functions, inthat it allows water vapour to escape outward, after it has been allowedto enter into the absorbing structure as fluid exudate. To avoid thein-growth of tissue and vessels, it comprises perforations or pores,which are selected in their size in such a manner so that the granulatedtissue of the wound, especially at the edge of the wound, cannotpenetrate into the enclosure. For example, the perforations or porespresent at the circumference of the enclosure can be smaller than thoseof the remaining enclosure surface.

The enclosure can be manufactured from natural materials, such as wovencotton or silk, or from perforated plastic sheeting or from plastictissue. The enclosure surrounding the pad can be manufactured partly orcompletely from a so-called wound distance lattice, whereby theplacement of its smooth or rough side is dependent on the respectivepurpose. The smooth side protects the wound from irritation andundesirable influences of a secondary bandage, whereas the rough sidenot only performs this function, but also actively scrubs the woundduring movement and thus can provide a desirable chemotactic stimulusfor the formation of new tissue.

In contrast to the known types of moist therapy, the absorbing structureaccording to the invention can be used without being wet.

At selected locations of the absorbing structure or the pad asignificantly higher quantity of comparatively small, fast absorbingsuper-absorbent particles may be present than elsewhere, so that thefunction of a wound filler develops locally during the course of theabsorption process.

If a wound-filling function is desired, an enclosure with surfaces ofdiffering elasticity is offered. In particular, the surface toward thewound may comprise a larger elasticity than the opposite surface lyingaway from the wound.

Furthermore, the absorbing structure may be supported by at least onefoam material layer, which is attached to the enclosure by means of atleast one adhesive point or by a peripheral seam. The foam materiallayer may be open- or closed-pore, hydrophilic or hydrophobic. Ifclosed-pore foam material is employed, then it is recommended tointroduce continuous openings through the foam material.

The enclosure with the pad applied therein as well as the foam materiallayer may be arranged within an external, liquid-permeable encasing.

The absorbing structure according to the invention may be designated asuniversal, since it is suitable for various wound therapies (ulcuscruris, cut wounds, scrape wounds, inflamed wounds, burns, etc.), woundhealing phases, as well as for use in collection means, such asdrainages, stomata, fistulae, or other collection bags.

The possible addition of for example synthetic compounds such astensides, or other materials named in claims 60-65, leads to asignificantly increased exudation of a wound and can be desirable. Herein particular, biocompatible and systemically or locally harmlessmaterials should be used, so as not to disturb the complex linkages ofinteractions of pressure conditions, perfusion, venous removal, cellularmetabolism, motility, and cellular inertness of cells such aserythrocytes and granulocytes, of the body's own or supplied growthfactors, immune-relevant cells and materials, or other factorsmeaningful for the growth of tissue. A possible vascular dilatation inthe wound region can have a favourable effect, even when it is aconsequence of the addition of tensides, since the exudation of thewound region stands here in the foreground, and a deep cleansing of thewound region may occur. This also concerns the visually recognizablewound base, the causal-therapeutically relevant wound base, as well asthe wound edge, tissue sections that are protected from exudation andharmful materials in that the super-absorbent granulate or other woundcontact areas (such as foams consisting of PU, PE, or other polymers,cellulose, alginates, hydraulic gels, carbon compounds, silvercompounds, honey, fleece materials, non-wovens, antiseptics, carriers ofthese materials, sheets or lipid-impregnated surfaces) fulfil thisfunction.

These additions such as the ten sides or the other listed materials maybe covalent, dissolvable, or loosely connected to other surfaces.

Some of the components may comprise various hole structures, whichfacilitate the interactions of the layers above. The transfer into thenearby layers is thereby facilitated in both directions, (both) additiveto and extractive from the wound.

Additional advantages are achievable in combination with a foamconstruction within a common further, external enclosure. Two forms ofwound relief are achieved:

For strong exudation, the side is applied to the wound, on which theabsorbing structure shows toward the surface of the enclosure, and bymeans of the desired strong absorption effect, the wound care articlerelieves the wounded area, in that it extracts the undesirablepathologic exudate, which comprises harmful hormonal and componentmaterials. Interstitial, intercellular, as well as cellular and alsovascular spaces achieve close to a physiological irrigation, so thatperfusion, arterial influx, venous recovery, and trans-membranousdiffusion are optimized, and not by means of long diffusion paths whichare interfered with by pathologic aqueous solutions and reactivebio-relevant enzymes. For cell growth requires the arterial influx ofproteins, oxygen, as well as the contributions from vessels, nerves, andfunctional supports of the immune defence.

For weaker exudation, the foam side can be applied to the wound. Herethe absorbing structure achieves an indirect factor for wound relief, inthat it uses its absorptive strength to dry the reverse side of thefoam. For this it is necessary that the foam is nearly soaked, so thatthe current flow through the foam is achieved through (for example)capillary effects, and develops as a gentle inflow into the absorbingstructure. Here the absorbing structure dries the back of the foam andforms a secondary reservoir, which adds the capacity of the absorbingstructure to the capacity of the foam, even though it does not havesignificant contact with the wound.

The enclosure, which surrounds the foam and the absorbing structure inthis construction form may be formed from perforated PE sheeting, whichcomprises crater-shaped holes of uniform or differing geometry.

The principle of the individual absorbing structure according to theinvention makes it possible to carry out a simplified visual check ofthe emitted wound exudate with the use of absorbing structuresinterspersed with super-absorbent particles, provided that the absorbingstructure is employed in the form of set sizes adjusted corresponding tothe wound.

A great advantage is that the absorbed wound exudate can take and remainat a set position in the absorbing structure, so that the surroundingskin near the wound is not attacked by the wound exudate.

To facilitate a general understanding of the functional method, itshould be emphasized again:

Bandage for local drainage of human tissue structures

Conditions of over-hydration in human tissue are found at multiplelocations. For example, advanced kidney failure may be the fundamentalcause of this effect, and progressive transfusion therapies may lead tosystemic over-hydration.

The cases described lead primarily to a systemic over-hydrationaffecting the entire body. This may also be a late effect of leftventricular insufficiency, in which the blood initially slows within theleft side of the heart, then in the lung, and than later in the entirelow-pressure (circulatory) system. In the end, a general susceptibilityto oedema then occurs.

However, the left ventricular insufficiency is initially a conditionwhich first leads to a blood blockage in the lung and thus to apulmonary oedema. Here a local susceptibility to oedema exists first.

Independent of the therapy for the underlying fundamental illness, thephysician treats the over-hydration mentioned by increasing kidneyperformance, by administering diuretics, frequently high ceilingdiuretics of the type Furosemides (Lasix). Here the ascending curve ofHenle's loop leads to an inhibition of reabsorption, so that largerquantities of primary urine are excreted, and water is systemicallywithdrawn from the body, so that the oedematous fluids may be drawn backinto the organism. The local over-hydration is eliminated, and when thecause of the fundamental illness is effectively treated, the patient ishealed.

For the understanding of the extraction of water from the system bymeans of the kidney, a normal hydration at the oedemically endangeredlocation is sought. This procedure is parallel to othercausal-therapeutical steps lege artis of the initially selected therapyfor lung oedemas with the developments mentioned.

The oedema in the lung is treated directly, actively, systemically, andpharmacologically.

It should now be reflected that the long-term administration ofdiuretics is not indicated in all cases. Even the treatment of eachlocal over-hydration by means of diuretics is not indicated.

Such an over-hydration represents an oedema, which develops on the basisof a CVI (chronic venous insufficiency). The enclosing wall of the veinconcerned becomes more permeable because of pathological processes, andconsiderable quantities of aqueous components initially present in thevein intrude out into the space outside of the vein. This occursespecially near the bones in the ankle joint of the leg, since the bloodcolumn in the vein begins here, and the hydrostatic pressure is highesthere.

An over-hydration of the surrounding area, the healthy cells, the skin,and the cellular interstices develops. Diffusion of arterial andsignificant nutritious materials, as well as the removal of wastematerials through the veins is limited. The cells shift to a reducedmetabolic state, bio-relevant processes and delicately orchestratedmetabolic steps are halted, and the cells die. A venous ulcus crurisdevelops, breaks out through the skin, and remains over-hydrated for thelife of the patient.

The same process in the lung would be treated by means of increasedkidney performance, at least if the entire lung were affected.

Treatment of this over-hydration in the lower leg with help of diureticsis not indicated, since a multitude of medical reasons is against it.This would be an intrusion into complex cardiologic systems, and sincein the contrast to the pulmonary oedema acute mortal danger is notrecognizable here, other methods must be found.

Independent of this it remains to state:

Other solutions must be found, to withdraw the exuded liquids in such amanner such as the kidney would do.

In contrast with this realization, therapeutic practice employs theapplication of bandages with comparatively low absorptive strength andunsatisfactory retention. Often foam bandages are used, which underpressure release what little water has been extracted, along withcomponents that interfere with wound healing. The focus thus drifts tosurface of the wound and is occupied with treating resulting effects andcontrol of superficial cosmetic aspects.

Just how much the wound is actively retained by a deficiency of modernideas remains here unclear.

It is clear, however, that the oedema in the leg tissue is treatedindirectly, passively, locally, and physically.

Both therapy schemes have in common the combination of causal therapy(heart medication to strengthen the heart, and thus on the one handtreating the blood blockage in the lung, as well as wearing compressivesocks to treat the emission of exuded venous fluids) and symptomtreatments (diuresis for pulmonary drainage on the one hand, as well asthe application of supposedly strongly absorbent bandages on the other).

Whereas the functional limitations of lung tissue are regarded asthreatening, oedematous swelling of tissue near joints is held to betransitory and thus non-problematic. Here the first imbalance develops,which is understandable in a view toward vital functions andpreservation of life, but this shortcut underestimates patientsuffering, pain, chronic illness, costs, perhaps also loss of job, and amultitude of additional disadvantages. Every physician knows thatconsiderable numbers of prescribed compression socks are not wornappropriately or consistently. Here it develops that the primaryfunction of compressing leg tissue fits into the patient's everyday lifein only a few cases, since putting them on is very difficult (if at allpossible), and as regarded as very unpleasant. The patient sweats insummer, and removal is also often difficult.

The physician despairs because of the patient's deficient compliance andtries to make the sense of this therapeutic treatment clear, knowingwell that he will not have great success. The result is that eithercompression stockings are prescribed that produces too little pressure,but which are at least worn, or none at all are worn. Thecausal-therapeutic scheme, which for the lung lies in a medicationalincrease of heart performance, often fails for venous insufficiency,because this is achievable only by means of good compression therapy. Ifthis does not take place, or not ideally, the vein will continue toexude for the long-term.

The view toward truly consistent oedema treatment presently sees onlytherapy with reduced pressure systems (VAC therapy), since this pullsliquids at the depth of the emission point by means of sub-atmosphericpressure conditions.

However, since this chosen therapy also has a multitude ofdisadvantages, which reach from high costs and immobility, to highrequirements for application, up to cases of death, it is valid to lookfor a third scheme in addition to nephrological diuretics andvacuum-supported therapy schemes.

It would be advantageous if this were a simply usable bandage, whichmakes use of known physical relationships and conditions, and doeswithout pharmacological processes.

Here it appears meaningful to select a bandage, which achieves theadvantages of the sub-atmospheric (pressure) scheme, without needing tocombat the disadvantages of reduced air pressure, such as perhaps thecreation of air-tight and suction-tight chambers.

This succeeds by the use of significant osmotically reduced pressureconditions, which is placed in the form of an area-surfaced bandage onthe wound surface, and which connects with physical laws with a new typeof design.

A pad, which in the form of cellulose material is a carrier for SAPparticles, preferably has a total weight of more than 300 g/m², and hasmore than 50% of swelling material. The binding strength would lie at0.5 to 2 g NaCl in 0.9% solution.

By means of the desired bandage, such a high osmotic potential (1^(st)force) is placed in the wound, that liquids on the wound surface areimmediately absorbed. Their cohesive forces (2 n ^(d) force) transmitthese directional flow forces to neighbouring wound fluids, so that adeep-acting effect develops. In the depth of the wound, a flow directionfor the surplus wound fluids is defined, and because of multipleeffects, these are retained and continue.

Here the cohesive tendency of liquids and also their adhesive tendency(3^(rd) force) are to be mentioned, so that actually only little of theliquid directly experiences the osmotic suction, whose directionaleffect yet still reaches deeply. It is to be assumed that even deep inthe tissue a mechanism (4^(th) force) takes place between the cells,which develops on the basis of capillary ascension, so that thereby theretention of the definition of the flow direction is supported.

The deep compressive force (5^(th) force) of the permeable vein supportsthis effect, since it only has the peripheral exit for liquids and thustowards the skin. This would describe the fifth effective dimension,which, started by the high osmotic suction, leads to a relief of theover-hydration of the wound base.

The sum total of these factors leads to the sixth dimension. This isimportant for the cooperative functioning of the first five.

For this some preparation is necessary, because physical laws inconnection with the current important here for the measurement of theruling forces:

In physical terms, the cause of a current flow is always regarded as apressure difference Δp over the extent of the piping system. In ourcase, a pipe system does not exist in literal terms, but the tissue tobe transited may be regarded as a closed system, in which the woundsecretion must seek its own paths and channels. Here it is subject toinhibitory influences such as shear forces, flow resistance, frictionalconditions, mechanical pressure differences, thrust impulses, flowstrengths, changing diameters of the paths and channels, and othereffective dimensions such as viscosity. Here the liquid hardly flows,but only slows seeps out. Despite its slow flow, the conditions fordesignating it as laminar current do not exist; however, the higher rateof flow conditions for designating it as turbulent current also do notexist.

${Re} = \frac{\rho \; {v \cdot d}}{\eta}$

Assuming that for this the Reynolds number Re (an empirical quantitywhich describes a relationship between impulses (propulsive forces) anddampening possible through friction) lies below the transformation limitof 2300, it is reasonable to assume that laminar flow conditions arepresent for untreated ulcers that develop as mentioned. Constantconditions for flow direction and for rate of flow certainly do notexist; instead, mixtures of various laws apply, such as theHagen-Poiseuille equation

$j = {\frac{\pi \; r_{0}^{4}}{8\eta \; l}\Delta \; p}$

(describing the volume flow {dot over (V)}, i.e. the volume V per unitof time, which in laminar current flow of a viscous liquid through acapillary tube with radius r and length l) or Bernoulli's law

$w_{ges} = {{w_{pot} + w_{kin}} = {p + {\frac{1}{2}\rho \; v^{2}}}}$

(the total pressure is the sum of the static pressure p and the dynamicpressure build-up) or by the influence of the Fahraeus-Lindquist-effect(influence of the vessel diameter, axial migration).

In connection with this rather pure physical overview of flowconditions, it is important that in the untreated wound area variousphases, conditions, pressures, and flow rates exist. Static regionsneighbour upon dynamic ones, and uniform alignment is not found.

Here the above five forces finally come together, for the osmoticpotential of the SAP breaks through this disorder and creates adirectional definition for the wound fluid, in that it absorbs from thesurface and deep wound liquids are extracted by means of the sum totalof the forces named. The impulse upon the first water molecules into theinside of the bandage generates an impulse for all closely followingwater molecules, in that they are attached in chains with one another bymeans of the forces mentioned or also by means of “van der Waals”forces. The pull on the first link creates a pull on the last link, andin the sense of an independent, dynamic continuation of these processes,the water molecules follow this flow lastingly once it is started, sincethe osmotic downward gradient of the SAP creates a one-way street insidethe product.

Imagined illustratively, an absorbing structure develops, which takesadvantage of the mechanisms by means of which (for example) petrol tanksmay be emptied with the help of hoses, in that a hose is inserted in thetank, briefly sucked upon, and then the petrol can be directed into alower placed canister. Laws of gravitation and cohesion apply here,whereby in our case the downward gradient of osmotic force and cohesionapplies. For the understanding of these processes, a drain develops inthe tissue depth, directly within the spatial neighbourhood of thefailed vein where the fluid is emitted. The bandage placed on the woundsurface has its primary functional purpose exactly in this tissue depth,withdraws fluid there, and dehydrates the oedema. For this it actsthrough the tissue lying between the wound bed and wound base and sucksup perivenous trans-tissue over-hydration, without particularly standingin physical proximity of it. Just as a towel suck a puddle dry when acorner of it is placed in a small puddle, the high osmotic potentialwithdraws the sub-surface oedemas from the wound. Gently and mild to thebody, and especially without dehydrating cells or the air, the extent ofthe exudate flow through these channels regulates the absorptive force,in that for high quantities of exudate the product jumps in actively andturns rather toward the surface of the wound base, but for lowerquantities of humidity will weaken by means of evaporation processes. Inall cases, the principles of moist-therapy are respected and supported.

Thus a suction bandage is created, which in the context of thefunctional method of a vacuum cleaner using high osmotic pressure,gently but actively removes bio-relevant noxious substances such asgerms, toxins, proteases etc. Here the pathologic exudate is less aproblem of being worthwhile of conquering and damaging healing, ratherit becomes the opposite: an article promoting healing. It forms thetransport media for the cleansing absorption effect, and after entryinto the bandage is released to the wound as humidity again, once it hasbeen freed of its damaging substances, since these do not evaporate, butrather remain in the bandage. The bandage thus cleans parts of theexudate, after it has carried itself and other damaging items into thebandage.

It has found the path into the inside of the bandage, because it wasencouraged to flow in a predefined direction. This dynamic effect onrather static fluid in an area that can be reached only through surgeryand within the cellular interstices leads to the formation of flowchannels and thus to the relief of the perivenous tissue. In the courseif these processes the pathologic exudate opens the wound surface andthe wound depth for rinsing solutions and keeps the flow channels openthrough continuous flow.

In contrast to the VAC therapy mentioned above, the maximum absorptiveperformance is gradually and locally reduced over the duration of theapplication, and is thus not static in a manner such as electricallyoperated pump pressure, and therefore also less dangerous. The requiredabsorptive strength of the bandage, which is achieved by means of theSAP, is reduced and determined by the extent of the areas of theexisting exudation, so that here may be spoken of a suction strengththat is adapted to the wound, and nearly even learning. Depending on thewound healing phase and the condition of each square centimetre of thewound, an absorptive performance develops that is typical for therespective wound situation. It is astounding that the advantages of thevacuum-drawing VAC therapy is called so significant in the literature,but it still has not been said, why the therapy success is soinnovative. It is the imposition of a directional definition for flowdirections, the pull on deeply placed liquids, which promotes the inflowof materials promoting wound healing. To achieve the same effect bynon-atmospheric reduced pressure, which is produced by means of greatlyreduced osmotic pressure, seems to be a logical consequence of thisrealization, especially because of its advantages in respect to costsand patient safety.

In addition condition applies that in contrast to the VAC therapy, thebandage eliminates the rinsed-out germs and the perhaps infectiousexudate directly after extraction from the body, and fights the germsimmediately after they flow into the bandage, without their beingdirected into a canister, whereas no anti-microbial additives are as yetpresent in the channelling hose and the can. This endangers personnel,and in particular cases, endemically or epidemically relevant germs maybe disposed of only as expensive and cost-intensive infectious liquidwaste.

For this it is significant that the desired effect requires a pressureof at least ______ units per ______ size, since below these values thesuction is not sufficient. The immediate proximity of the carrier of theosmotic potential, which is created by means of the thin encasing towardthe wound base, brings this pulling force to its purpose.

This also permits another significant difference to other bandagematerials to become clear. For if these bandages, especially comprisingcellulose wool, fluff, or fleece material, come in contact withexudates, they immediate lose their structural integrity and degenerateto soaking. Already shortly after making contact with exudate, such abandage is wet and has lost its suction and pulling force, which alreadywas comparatively low when it was manufactured. In the face of thenecessity of extracting from the tissue depth, the appropriateness ofsuch a bandage as bandage material for a venous ulcus cruris may becalled into question. With the realization that similar illnesses may betreated with modern, hydro-active bandages such as polyurethane foams,it may be seen that here a step forward has been taken, but in fact onethat does not go far enough.

For exudate and germs form the breaking points for healing. Exudatesupports germs, and germs lead to exudate. Oedemas lead to reducedimmune response, and the vicious circle is closed. If this circulationis broken, the wound will close.

These thoughts reflect in particular that wounds are not homogenous andthe same at every point. Many wounds simultaneously experience allphases of wound healing, in that here they are necrotic and dead, thereinfected and covered, here exuding and watery, there fibrous, and hereagain hyper-granulated. Here the wound edge, there an inflammation, herefresh epithelial tissue, and there a bloody lesion due to painfulremoval of adhered bandages.

The automatic adaptation to these respective conditions succeeds bymeans of the bandage described here, because it corresponds with each ofthe wound situations mentioned, in that it delivers the correct responseat each location. Necrotic regions are softened by means of humidity andscrubbed, germs are extracted along with the exudate of the regionalinflammation, coatings are concentrated onto the external enclosingsurface and are removed along with the bandage when it is removed,aqueous exudate is withdrawn with a high retention force,hyper-granulation is slowed by the bandage through its own weight andthe weight of the extracted exudate, fresh epithelium is protected fromthe exudate and adhesion does not take place, and when it does, then atypical wound separation lattice may be used as primary bandage.

All typical advantages are optimized yet more, in that the bandage hasfull-surfaced contact with the wound. Here it is appropriate to reflectthat the surface of a wound is not smooth like a pane of glass, butrather comprises an extremely non-homogenous morphology. From theperspective of a small cell, a comparison with an aerial view of Germanyis thoroughly appropriate: in the south we have mountains, above thererather flat space, many tall buildings stand in metropolitan areas, andthere lie many lakes, and also perhaps once something under sea level.The realization that hardly any wound comprises just one healing phaseand only one healing situation, leads to the necessity of a bandage,which appropriately treats multiple phases simultaneously. This isensured by the selected technical scheme.

It may be recommended to use one of the mentioned foam bandages as thefull-surfaced primary contact layer, so long as the advantages of theabsorbing structure find additional use. This could occur in that thefoam has contact with the wound, and the absorbing structure is applieddirectly on the reverse, first to ensure the adjustment to a verynon-homogenous wound base morphology by means of a foam, which asflow-through and contact structure transfers the wound fluids directlyin the absorbing structure. It is also conceivable to fulfil thisfunction by means of alginates, carbon bandages, or cotton and fleecematerials.

When PU foams are used, these tend to roll up at their edges. The use ofan absorbing structure on the reverse creates a desirable mechanicalcounter-force here, and contributes to retaining full-surfaced contactarea.

The exterior form of the bandage may exist in the form of squares orother geometries, but may also have anatomic forms such as (for example)gloves for the treatment of extremities.

Of primary importance in all cases is that a new understanding developsfor wound treatment, oedema therapy, and treatment of vascularinsufficiency, in that emitted venous liquid, oedemas and their liquidsare made dynamic and directed to the skin surface, to be powerfullywithdrawn there, so that the wound can close. De-stressing, swellingreduction, damming, and the withdrawal of damaging materials lead torelief, deep recovery, and tissue de-blockage, which is cleansed fromthe deep perivenous tissue up to the wound base by means of this rinsingprocess.

This new understanding also contains the option of being combinable withVAC therapy, to achieve a strengthening of the suction performance.Modifications are conceivable, by means of which reduction of the airsuction is made possible, since osmotic suction performance is added toit, and thus permit regulating synergetic factors.

In all cases, with or without VAC, the body exudates and waste products,which are carried into the absorbing structure by means of the rinsingeffect, are collected.

Synergetic factors may also have reciprocal effects, for example, incases where for example the exudate is encouraged and increased by meansof tensides, the use of the absorbing structure is necessary to controlthe aroused exudation.

Other additives may also be natural materials, for example, extracts offruits or nuts, to be mentioned here are in particular saponins, theextracts of “soap nuts”.

The swelling materials may lead to a reduction of the germ count in thewound region by means of ion exchange processes, in that depolarizationand its transfer is obstructed, or in that concentration gradients atthe cell membranes of organisms and germs are reduced. Here thetreatment of resistant germs may play an endemic or epidemic role, forthe colonized wound often supports the germs and the germs often supportthe wound. The breaking of this (cycle) is a considerable measure forcontaining the spread of germs and their infections.

The possibility of depositing super-absorbent granulate in a bed of cutand folded cellulose fibres, before they swell, plays a considerablerole here for the production of humidity in the wound area, because thedesired maximization of surface area is thereby achieved. Coveringlayers comprising cellulose, high surface area granulate, andsurface-area-intensive fibres lead in concert to much space and muchsurface area for the evaporation of retained fluid components, and thusfor the production and maintenance of desirably moist woundenvironments.

This form of pad as SAP carrier exists in particular as the (so-called)“airlaid” type.

Non-systemic, local, but necessary drainage, such as diuretics and thekidney would provide for the lung, are thus effected by means of anexudate-hungry bandage comprising with high osmotic potential. For it isnot acceptable that skin and connective tissues must die, merely becausea vein should fail.

For only by means of these rinsing processes is it conceivable totransport impurities, germ remains, cellular remains, metabolic productsof bacteria, and cells present in the wound region to the surface, thusto absorb them directly there and to remove them in a controlled manner.

APPENDIX 2 Claims of the Patent DE 102006047041 (Priority Application)

-   1. An surface-area absorbing structure (100; 101; 102; 103) for    application to human as well as animal body surfaces, especially for    extraction and control of wound fluids, such as pathological wound    exudate from the depth of the wound base, which wound exudate the    formation of humidity present in the wound region because of    evaporation processes aqueous sections of the extracted exudate    caused, comprising:    -   at least one fluid-absorbing pad (1; 11; 21) with uniform colour        surface,    -   a quantity of super-absorbent particles (20), which are        distributed on or in the pad and which accelerates the        absorption of wound exudate,    -   and at least one the pad (1; 11; 21) surrounding, at least        partly liquid-permeable enclosure (10),    -   whereby the super-absorbent particles (20) are essentially white        or naturally coloured,    -   characterized in that:    -   after application to the wound (30) and direct moistening with        the wound fluid, the pad (1; 11; 21) marks the respective wound        areas (34) and the exterior contour (31) of the wound in colour        through the retention of the pad's originally-coloured surface        areas (33), whereby the pad (1; 11; 21) reaches past the        respective wound edge in the applied condition of the absorbing        structure, and covers healthy skin areas all around the wound,    -   and that the pad (1; 11; 21) changes its thickness (D) in such a        manner, that the thickness increases proportionally        corresponding to the local absorption conditions related to        osmotic or atmospheric pressure; whereas the original        thickness (D) of the pad remains unchanged for the mentioned        adjoining surface areas (33).-   2. The absorbing structure according to claim 1, characterized in    that it serves for:    -   placement on human and animal surfaces, and for    -   mounting on surfaces of chronic and acute wounds,    -   reduction of over-hydration in peripheral tissue layers, which        have contact with the ambient air,    -   reduction of over-hydration in covered and deeper tissue layers,        which do not have contact with the ambient air        and comprises at least a quantity of osmotically active swelling        material such as super-absorbent granules,        and    -   in the absorbing structure a quantity of materials is present,        which have influence to reduce germ count,    -   at least portions of the swelling materials have a lower        retention and binding strength for water than its vapour        pressure and steam pressure are, and therefore moist wound        conditions can be created from extracted liquids,    -   the osmotic pressure of the absorbing structure before use can        bind more than 0.3 g of 0.9-% NaCl solution per square        centimetre, because of the selection and quantity of the        swelling materials,    -   so that        the hydrostatic counter-pressure in spatial proximity to tissue        structures losing bodily fluids in pathologic dimensions is        reduced through cohesive forces and osmotic pressure differences        for covered tissue layers, whereby the oedematous compression        and the over-hydration of bodily tissue is reduced.-   3. surface-area absorbing structure for use with chronic    non-homogeneous wounds, especially to dissolve and to absorb germs    anchored on the wound surface and/or in the wound base, comprising:    -   at least one fluid-absorbing fleece pad (1; 11; 21),    -   A quantity of super-absorbent particles (20), which are        distributed on or in the fleece pad and accelerate the        absorption if pathological wound exudate,    -   and at least one enclosure (10) surrounding the fleece pad (1;        11; 21) that is at least partially liquid-permeable,    -   characterized in that        -   the absorbing structure is applicable on the respective            wound surface in a dry condition that is not influenced by            foreign, non-bodily liquids.    -   after application to the wound (30) and direct moistening with        the wound fluid, the fleece pad (1; 11; 21) intrudes into the        respective wound areas (34) at least locally and produces a        suction on the wound surface, which acts with an osmotic        pressure in the wound base directed toward the wound surface,        and which the germs present there are continuously rinsed out by        means of enclosed wound exudate, and are transported into the        fleece pad (1; 11; 21) enriched with super-absorbent particles        (20) by means of the perforations on the enclosure (10), in that        the steam pressure of the aqueous portions of the wound exudate        are higher than the retentive strength of the selected        super-absorbent particles (20).-   4. The absorbing structure according to claim 1, characterized in    that    -   the fleece pad (1; 11; 21) reaches past the respective wound        edge in the applied condition of the absorbing structure, and        covers healthy skin areas all around the wound,    -   and that the pad (1; 11; 21) changes its thickness (D) in such a        manner, that the thickness increases proportionally        corresponding to the local absorption conditions related to        osmotic or atmospheric pressure; whereas the original        thickness (D) of the pad remains unchanged for the mentioned        adjoining surface areas (33).-   5. The absorbing structure according to claim 1, characterized in    that the enclosure (10) is encircled by a seam (6), which defines a    first surface (F1), which is at least 5% larger than a second    surface (F2) defined by an outline (U) of the pad.-   6. The absorbing structure according to claim 4, characterized in    that corresponding to pressure conditions on the wound permitting,    the seam (6) is a long-lasting deformable ultrasonic weld seam.-   7. The absorbing structure according to any of the preceding claims,    characterized in that the absorbing structure is covered or    supported on at least one of its surfaces by at least one alginate    or foam pad (41).-   8. The absorbing structure according to claim 5, characterized in    that the alginate or foam pad (41) is peripherally attached to the    enclosure (10).-   9. The absorbing structure according to claim 5, characterized in    that the alginate or foam pad (41) is affixed to the enclosure (10)    by means of at least one adhesive point (42) or adhesive line.-   10. The absorbing structure according to one of the claims 5 to 7,    characterized in that the enclosure (10) with the therein applied    fleece pad as well as the alginate or foam pad (41) within an    external, additional liquid-permeable encasing (43) arranged are.-   11. The absorbing structure according to any of the preceding    claims, characterized in that it generates an osmotic pressure for    fluid flow directions from the wound base peripherally to the skin,    which in total with the oedematous hydraulic pressure in the same    direction, creates a dynamic flow direction from the wound base into    the inside of the absorbing structure, so that the wound fluids    enter the visually recognizable wound base, which has contact to the    ambient air, and upon which the absorbing structure is applied,    without remaining statically on it in the form of oedema-producing    accumulations, but instead remain bound in the absorbing structure    in the form of water vapour and humidity, and remain in the wound    region until the bandage is exchanged.-   12. The absorbing structure according to any of the preceding    claims, characterized in that the absorbing structure generates an    osmotic pressure for fluid flow directions from the wound base    peripherally to the skin, which in total with the oedematous    hydraulic pressure in the same direction, creates a dynamic flow    direction from the wound base into the inside of the absorbing    structure, so that the wound fluids enter the visually recognizable    wound base, which has contact to the ambient air, and upon which the    absorbing structure is applied, and enter into the absorbing    structure, whereby in relationship with rinsing processes and    traction it rinses its germs and impurities from the wound surface    into the inside of the absorbing structure, so that this suction    acts against the stability or even the increase of germ counts.-   13. The absorbing structure according to any of the preceding    claims, characterized in that the absorbing structure produces by    means of the swelling process a relative depletion of electrolytes    such as potassium, calcium, magnesium, etc. in the absorbed liquids    in the space within the enclosure (10), whereby    environment-dependent or concentration-dependent mechanisms (such as    depolarization, cell wall stability of germs, or gradients in the    electronegativity for microbes such as bacteria, fungi or their    spores in only limited development) occur to attack the microbes, so    that for example, bacteriostatic or bactericidal influences develop.-   14. The absorbing structure according to claim 1, characterized in    that the absorbing structure is applicable on the respective wound    surface in a dry condition that is not influenced by foreign,    non-bodily liquids.-   15. The absorbing structure according to claim 1, characterized in    that the pad (1; 11; 21) locally impregnated with the wound fluid at    least partially fills the respective wound.-   16. The absorbing structure according to claim 1 or 2, characterized    in that the absorbing structure is covered or supported by a    perforated material section that protects the wound, or is attached    or peripherally connected to one such (material section).-   17. The absorbing structure according to any of the preceding    claims, characterized in that the pad (1) comprises a core layer (3)    and at least one enclosing sheets (12.1, 12.2).-   18. The absorbing structure according to any of the preceding    claims, characterized in that the super-absorbent particles (20) are    present in the core layer (3) as distributed cellulose fibres, which    core layer (3) is contained by two enclosing sheets (12.1, 12.2) of    cellulose.-   19. The absorbing structure according to any of the preceding    claims, characterized in that the material containing cellulose    comprises random fleece, whose fibre sections (13) wrap at least    partly around the super-absorbent particles (20).-   20. The absorbing structure according to any of the preceding    claims, characterized in that the absorbing structure comprises a    differing, material-dependent absorptive performance on each of its    two sides.-   21. The absorbing structure according to any of the preceding    claims, characterized in that the pad (11) comprises two layers    (7.1, 7.2) that are stacked on top of each other or folded together,    between which the super-absorbent particles (20) are arranged.-   22. The absorbing structure according to any of the preceding    claims, characterized in that the pad (11) comprises two layers    (7.1, 7.2) that are stacked on top of each other or folded together,    at least one of which is distributed with a quantity of    super-absorbent particles (20).-   23. The absorbing structure according to any of the preceding    claims, characterized in that the layers (7.1, 7.2) are separated    from one other by a dividing wall (32).-   24. The absorbing structure according to claim 11, characterized in    that the dividing wall (32) is impermeable to liquids.-   25. The absorbing structure according to claim 12, characterized in    that the dividing wall (32) is perforated.-   26. The absorbing structure according to claim 12, characterized in    that at least one surface of the absorbing structure, for example,    the dividing wall (32), is impermeable to liquids, but permeable to    water vapour.-   27. The absorbing structure according to any of the preceding    claims, characterized in that the super-absorbent particles (20) are    arranged over the surface on at least one of the upper sides (14.1,    14.2) of the pad.-   28. The absorbing structure according to any of the preceding    claims, characterized in that at least one location of the absorbing    structure a significantly higher quantity of comparatively small,    fast absorbing super-absorbent particles (20) is locally present    than elsewhere, so that the function of a wound filler develops    locally during the course of the absorption process.-   29. The absorbing structure according to any of the preceding    claims, characterized in that bio-relevant materials of atomic or    elementary basis, such as perhaps silver compounds, growth factors,    activated charcoal surfaces, antiseptics, tensides, and carrier    substances for these materials are added to the pad (1).-   30. The absorbing structure according to any of the preceding    claims, characterized in that the enclosure (10) is surrounded by a    seam (6), which defines a first surface (F1), which is at least 5%    larger than a second surface (F2) defined by an outline (U) of the    pad.-   31. The absorbing structure according to claim 18, characterized in    that the seam (6) is an ultrasonic welded seam that is flexible, and    remains deformable according to the pressure conditions on the    wound.-   32. The absorbing structure according to any of the preceding    claims, characterized in that the pad or core layer (3) and/or    enclosing sheets (12.1, 12.2) are woven in form.-   33. The absorbing structure according to any of the preceding    claims, characterized in that the pad is of “airlaid” type.-   34. The absorbing structure according to any of the preceding    claims, characterized in that the absorbing structure is covered or    supported on at least one of its surfaces by at least one foam    material layer (41).-   35. The absorbing structure according to claim 22, characterized in    that the foam material layer (41) is peripherally attached to the    enclosure (10).-   36. The absorbing structure according to claim 22, characterized in    that the foam material layer (41) is affixed to the enclosure (10)    by means of at least one adhesive point (42) or an adhesive line.-   37. The absorbing structure according to one of the claims 22 to 24,    characterized in that the enclosure (10) with the therein applied    pad as well as the foam material layer (41) are arranged within an    additional, liquid-permeable external encasing (43).-   38. The absorbing structure according to any of the preceding    claims, characterized in that the pad (1; 11; 21) is freely movable    within the enclosure (10).-   39. The absorbing structure according to any of the preceding    claims, characterized in that the pad (1; 11; 21) is affixed within    the enclosure (10).-   40. The absorbing structure according to any of the preceding    claims, characterized in that the surfaces (2.1, 2.2) of the    enclosure or its contents comprise different elasticities.-   41. The absorbing structure according to claim 28, characterized in    that the surface (2.1) near the wound comprises a larger elasticity    than the other surface (2.2).-   42. The absorbing structure according to claim 28, characterized in    that at least one surface, for example, the surface (2.2) away from    the wound, comprises an insignificant elasticity approaching or    equal to the zero value.-   43. The absorbing structure according to any of the preceding    claims, characterized in that the enclosure (10) comprises a border    hem (9), in that the seam (6) does not lie on the outermost    circumference of the enclosure (10), but rather leaves a gap (15) in    the enclosing material.-   44. The absorbing structure according to any of the preceding    claims, characterized in that surface-active substances, which have    an affinity for germ surfaces are added to the absorbing structure.-   45. The absorbing structure according to any of the preceding    claims, characterized in that the absorbing structure comprises an    extractive capacity that is at least 50 g of water per 100 cm² of    the pad's (1; 11; 21) surface, measured according to DIN 53923.-   46. The absorbing structure according to any of the preceding    claims, characterized in that the absorbing structure is a    hydro-active wound bandage, which permits extracted liquid to    evaporate.-   47. The absorbing structure according to any of the preceding    claims, characterized in that the super-absorbent particles (20) are    composed of sodium acrylate/acrylic acid polymerisations.-   48. The absorbing structure according to any of the preceding    claims, characterized in that the super-absorbent particles (20) are    ceramic.-   49. The absorbing structure according to any of the preceding    claims, characterized in that the enclosure (10) comprises weight of    at least 15 g/m², preferably 25 g/m² to 35 g/m².-   50. The absorbing structure according to any of the preceding    claims, characterized in that odour-limiting materials, such as    activated charcoal, are added to the absorbing structure.-   51. The absorbing structure according to any of the preceding    claims, characterized in that bactericidal materials, such as silver    compounds, are added to the absorbing structure.-   52. The absorbing structure according to any of the preceding    claims, characterized in that additives that fall under medical    regulations are supplied to the absorbing structure, for example,    mineral corticoids, proteases, antibiotics, anti-inflammatory    agents, antipyretics, analgesics, anticonvulsive additives, or    growth factors.-   53. The absorbing structure according to any of the preceding    claims, characterized in that the absorbing structure is part of a    compression system or of a reduced pressure system.-   54. The absorbing structure according to any of the preceding    claims, characterized in that the absorbing structure is part of a    post-operative drainage system.-   55. The absorbing structure according to any of the preceding    claims, characterized in that the absorbing structure is part of an    occlusive or semi-occlusive bandage.-   56. The absorbing structure according to any of the preceding    claims, characterized in that lipo-colloids are added to the pad (1;    11; 21) and/or the enclosure (10).-   57. The absorbing structure according to any of the preceding    claims, characterized in that the super-absorbent particles (20)    comprises a concentration of remaining monomers that lies below 2000    ppm (units).-   58. The absorbing structure according to any of the preceding    claims, characterized in that the super-absorbent particles (20)    comprise a pH level that is less than 9.-   59. The absorbing structure according to any of the preceding    claims, characterized in that the super-absorbent particles (20)    comprise a size from 0.01 mm to 0.5 mm.-   60. The absorbing structure according to any of the preceding    claims, characterized in that the super-absorbent particles (20)    comprise a size from 0.5 mm to 3.0 mm.-   61. The absorbing structure according to any of the preceding    claims, characterized in that the super-absorbent particles (20)    comprise various particle sizes, for example, mixtures particles    with size differences in the region of a factor of 5.-   62. The absorbing structure according to any of the preceding    claims, characterized in that the super-absorbent particles (20) are    glued onto the pad.-   63. The absorbing structure according to any of the preceding    claims, characterized in that the super-absorbent particles (20) are    embedded, for example pressed into in the pad.-   64. The absorbing structure according to any of the preceding    claims, characterized in that the super-absorbent particles (20) are    sprayed onto the pad.-   65. The absorbing structure according to any of the preceding    claims, characterized in that the absorbing structure comprises    additives, which have characteristics of ion reserves, in that on    exposure to corresponding ions exchange processes occur, whereby in    particular potassium as well as magnesium are bound.-   66. The absorbing structure according to any of the preceding    claims, characterized in that the super-absorbent particles (20)    comprise a core network, present as Core-Cross-Linker (CXL) or also    as Surface-Cross-Linker (SXL), or a mixture of both.-   67. The absorbing structure according to any of the preceding    claims, characterized in that the absorbing structure extracts the    materials occurring in the wound and selectively releases the    aqueous portions again, in that the vapour pressure of the water is    higher than the retentive strength of the selected super-absorbent    particles (20).-   68. The absorbing structure according to any of the preceding    claims, characterized in that the absorbing structure is to be used    in the cleansing phase of the wound.-   69. The absorbing structure according to any of the preceding    claims, characterized in that the super-absorbent particles (20)    comprise strong cytotoxic and thus bactericidal or bacteriostatic    characteristics, which in the course of the absorption process are    reduced or eliminated by means of the inflowing exudate and the ions    contained therein, without the application of electrolytic solutions    before use.-   70. The absorbing structure according to any of the preceding    claims, characterized in that the absorbing structure is usable as    secondary construction.-   71. The absorbing structure according to any of the preceding    claims, characterized in that the absorbing structure is usable as    primary or tertiary bandage.-   72. The absorbing structure according to any of the preceding    claims, characterized in that molecules or compounds from the group    containing detergents, tensides, or other chemically reactive    polymers are present on at least one of its surfaces.-   73. The absorbing structure according to any of the preceding    claims, characterized in that these detergents comprise glycol    compounds containing carbon, such as PEG (polyethyleneglycol) or PPG    (polypropyleneglycol).-   74. The absorbing structure according to any of the preceding    claims, characterized in that these detergents are chemically    related with esters or ethers such as poloxamers, Meroxapol,    Poloxamin, or other block polymers.-   75. The absorbing structure according to any of the preceding    claims, characterized in that the detergents include silicone    polymers such as polyethoxylated and/or polypropoxylated silicone    polymers, substituted monomers or polymers ethoxylate or    propoxylate, alkylpolyglucoside (APG), or Aziridin-homopolymer (PEI,    polyethylenimine).-   76. The absorbing structure according to any of the preceding    claims, characterized in that these detergents are long-chained,    ionic (anionic such as SDS and SAS and ABS, cationic, amphoteric    such as poloxamine), and/or non-ionic, such as APG and FAEO and    FAPO.-   77. The absorbing structure according to any of the preceding    claims, characterized in that the detergent is a surfactant, or F-68    (Pluronic), or Triton X-100, or Tetronic 1307, or Surfynol 465, or    Surfynol 485, or Silwet L7600, or Cremophor EL, or Tween 20, or    Surfactant 10G, or a material group or type related to or associated    with these materials, or a mixture of similar materials.-   78. The absorbing structure according to any of the preceding    claims, characterized in that a carrier, such as a pad of alginates,    cellulose, honey, fleece, cotton wool, or carbon compounds is    present together with the materials listed in claims 60 to 65 in an    enclosure comprising at least partially of liquid-permeable    material.-   79. The use of an absorbing structure according to any of the    preceding claims for chronic and acute wounds, for compartment    syndromes, burn wounds, locations with separated dermis, and for    contact with human organ systems such as intestinal, peritoneum,    cavities, tumour tissue, iatrogenically supplied areas, ascites, and    organ contents such as escaping intestinal contents, gall-bladder    fluids, pancreatic fluids, or stomach fluids.-   80. The use of an absorbing structure according to any of the    preceding claims to produce or maintain moist wound conditions,    whereby at least one of the absorbing structure's preceding claims    may take part in the production or maintenance.-   81. The absorbing structure according to any of the preceding    claims, characterized in that it is present in the neighbourhood of    a foam construction or an alginate pad or a carrier surface with    additives such as the above, in an additional common enclosure,    which has been thermally sealed, for example, by means of    ultrasound, or which has been glued.-   82. The absorbing structure according to any of the preceding    claims, characterized in that super-absorbent particles are present    at an additional location rather than in the absorbing structure    itself, for example, in a foam, on a surface of the enclosure, on    intermediate surfaces, or on other surfaces of the bandage.-   83. The absorbing structure according to any of the preceding    claims, characterized in that with increasing filling the free air    regions in the enclosure gradually become filled, so the absorbing    structure approaches a circular shape by means of the swelling    process, and by volume and weight increase, whereby reaching the    circular (shape) is strongly dependent on the seam and the product    axis that results from it.-   84. The absorbing structure according to any of the preceding    claims, characterized in that with the flow of wound fluids into the    inside of the product, cellular remains, waste products, and germs,    which may perhaps be pathogens or even multi-resistant, are    absorbed, whereby the germs experience ambient conditions that are    hostile for their life, since dehydration, ion exchange, a deficient    nutrient base, and the presence of oxygen may be significant here.-   85. The absorbing structure according to any of the preceding    claims, characterized in that it generates an osmotic pressure for    fluid flow directions from the wound base peripherally to the skin,    which in total with the oedematous hydraulic pressure in the same    direction, creates a dynamic flow direction from the wound base into    the inside of the absorbing structure, so that the wound fluids    enter the visually recognizable wound base, which has contact to the    ambient air, and upon which the absorbing structure is applied,    without remaining statically on it in the form of oedema-producing    accumulations, but instead remain bound in the absorbing structure    in the form of water vapour and humidity, and remain in the wound    region until the bandage is exchanged.-   86. The absorbing structure according to any of the preceding    claims, characterized in that it generates an osmotic pressure for    fluid flow directions from the wound base peripherally to the skin,    which in total with the oedematous hydraulic pressure in the same    direction, creates a dynamic flow direction from the wound base into    the inside of the absorbing structure, so that the wound fluids    enter the visually recognizable wound base, which has contact to the    ambient air, and upon which the absorbing structure is applied, and    enter into the absorbing structure, whereby in relationship with    rinsing processes and traction it rinses its germs and impurities    from the wound surface into the inside of the product, so that this    suction acts against the stability or even the increase of germ    counts.-   87. The absorbing structure according to any of the preceding    claims, characterized in that the it produces by means of the    swelling process a relative depletion of electrolytes such as    potassium, calcium, magnesium, etc. in the absorbed liquids in the    space within the enclosure (10), whereby environment-dependent or    concentration-dependent mechanisms (such as depolarization, cell    wall stability of germs, or gradients in the electronegativity for    microbes such as bacteria, fungi or their spores in only limited    development) occur to attack the microbes, so that for example,    bacteriostatic or bactericidal influences develop.    End of the Appendix

1. A wound care article for extraction and control of wound fluids,comprising: at least one first fluid-absorbing structure, which issurrounded by a liquid-permeable, first enclosure, and aliquid-permeable second enclosure, comprising two enclosing surfaces,characterized in that the first enclosure is covered or supported on atleast one of its flat sides by at least one fluid-absorbing materiallayer, which is arranged between the first enclosure and one of theenclosing surfaces of the second enclosure.
 2. The wound care articleaccording to claim 1, characterized in that the first enclosure issurrounded by the second enclosure.
 3. The wound care article accordingto claim 1, characterized in that the first enclosure and the secondenclosure with the therein applied first structure and the materiallayer form a bandage booklet, in that both enclosures are foldable bymeans of at least one fold line (X) or a long or spot joint.
 4. Thewound care article according to claim 3, characterized in that for thebandage booklet, the first enclosure merges in one piece into the secondenclosure.
 5. The wound care article according to claim 1, characterizedin that the material layer consists of foam material.
 6. The wound carearticle according to claim 1, characterized in that the material layercomprises Cellulose, especially methylcellulose.
 7. The wound carearticle according to claim 1, characterized in that the material layercontains alginate.
 8. The wound care article according to claim 1,characterized in that the first fluid-absorbing structure is smaller insurface area than the material layer.
 9. The wound care articleaccording to claim 1, characterized in that the first fluid-absorbingstructure and the material layer are essentially the same in surfacearea.
 10. The wound care article according to claim 1, characterized inthat the enclosing surface of the second enclosure simultaneously formsan enclosing surface of the first enclosure, the enclosing sheet of thefirst enclosure is attached by means of an encircling seam with theenclosing surface of the second enclosure, and that the first enclosureis smaller in surface area than the second enclosure.
 11. The wound carearticle according to claim 1, characterized in that the first enclosurecomprising two enclosing sheets is attached by means of an encirclingseam with the enclosing sheet of the second enclosure. and that thefirst enclosure is smaller in surface area than the second enclosure.12. The wound care article according to claim 1, characterized in thatthe first fluid-absorbing structure is present in form of a tissue orfleece-like pad.
 13. The wound care article according to claim 12,characterized in that the pad contains alginate.
 14. The wound carearticle according to claim 12, characterized in that the pad is of“airlaid” type.
 15. The wound care article according to claim 1,characterized in that the first fluid-absorbing structure is present inthe form of a casting, a pressing, and/or in the form of shavings. 16.The wound care article according to claim 1, characterized in that thefirst fluid-absorbing structure and/or the material layer comprises atleast one super-absorbent substance.
 17. The wound care articleaccording to claim 12, characterized in that the fleece-like structurepresent within the first enclosure is supported by a pad containingalginate, which is likewise arranged within of the first enclosure,whereby the pad containing alginate is to the reverse of the materiallayer.
 18. The wound care article according to claim 1, characterized inthat an alginate layer is covered over the material layer, which liesbetween the material layer and the enclosing surface of the secondenclosure.
 19. The wound care article according to claim 1,characterized in that the material layer is peripherally attached to thefirst enclosure.
 20. The wound care article according to any of thepreceding claim 1, characterized in that the material layer is affixedto the enclosing sheet of the first enclosure by means of at least oneadhesive point or an adhesive line.
 21. The wound care article accordingto claim 1, characterized in that the first fluid-absorbing structure isfreely movable within the first enclosure.
 22. The wound care articleaccording to claim 1, characterized in that the first fluid-absorbingstructure is fixed within the first enclosure.
 23. The wound carearticle according to claim 1, characterized in that at least thematerial layer is perforated at least in sections.
 24. The wound carearticle according to claim 1, characterized in that at least theenclosing surfaces of the second enclosure are hydrophobic.
 25. Thewound care article according to claim 1, characterized in that the firstand/or the second enclosure comprises one rough interior surface and onesmooth exterior surface.
 26. The wound care article according to claim25, characterized in that the rough interior surface of the first and/orof the second enclosure is created by means of funnel-shapedperforations introduced into the enclosing material.
 27. The wound carearticle according to claim 25, characterized in that the smooth exteriorsurface of the first and/or of the second enclosure comprises curvedmaterial fields, extending between the perforations.
 28. The wound carearticle according to claim 25, characterized in that both the interiorsurface and also the exterior surface of the internal and/or of theexternal enclosure are smooth.
 29. The wound care article according toclaim 1, characterized in that the first enclosure and/or the secondenclosure manufactured plastic sheeting, in particular a polyurethane orpolyethylene foil.
 30. The wound care article according to claim 1,characterized in that the first enclosure and/or the second enclosure ismanufactured from silk sheeting, especially from artificial orrecombinant spider web sheeting.
 31. The wound care article according toclaim 1, characterized in that the enclosing surfaces of the secondenclosure comprise in each case peripheral adhesive strips on both ofits flat sides.
 32. The wound care article according to claim 31,characterized in that the adhesive strips are in each case provided witha removable, sheet-like protective strip.
 33. The wound care articleaccording to claim 1, characterized in that a central opening isprocessed on the hydrofibre or foam material layer, in which an insertcontaining alginate is placed.
 34. The wound care article according toclaim 33, characterized in that the insert is released for directcontact with the respective wound through a window located on theenclosing surface of the second enclosure.
 35. The wound care articleaccording to any of the preceding claim 1, characterized in that thesuper-absorbent substance is present in the form of a granulate, apowder, a casting, a pressing, or a foam.
 36. The wound care articleaccording to claim 1, characterized in that the powder or granulate-likesuper-absorbent substance comprises a particle size of 25 to 2000 μm,preferably 100 to 1000 μm.
 37. The wound care article according to claim1, characterized in that the powder or granulate-like super-absorbentsubstance are present free of binding agents in at least one of thestructures or material layer.
 38. The wound care article according toany of the preceding claim 1, characterized in that the material layercomprising foam material is made of integral skin foam.
 39. The woundcare article according to claim 1, characterized in that it is part of areduced pressure system.
 40. The wound care article according to claim1, characterized in that it is part of a compression system.
 41. Thewound care article according to claim 1, characterized in that thesecond enclosure is polygonal, especially rectangular.
 42. The woundcare article according to claim 1, characterized in that the secondenclosure is oval or circularly round.
 43. The wound care articleaccording to claim 1, characterized in that within the second oval orcircular enclosure a polygonal, in particular rectangular internalenclosure is arranged.
 44. The wound care article according to claim 43,characterized in that the first enclosure reaches with its corners tothe encircling seam of the second oval or circular enclosure.
 45. Thewound care article according to claim 1, characterized in that at leastone of the enclosing surfaces of the second enclosure is covered by acovering sheet.
 46. The wound care article according to claim 45,characterized in that the covering sheet is applied loosely onto theenclosing surface of the second enclosure.
 47. The wound care articleaccording to claim 45, characterized in that the covering sheet isadhesive.
 48. The wound care article according to claim 45,characterized in that the covering sheet is impermeable to liquids andwater vapour.
 49. The wound care article according to claim 45,characterized in that the covering sheet impermeable to liquids, butpermeable to water vapour.
 50. The wound care article according to claim45, characterized in that the covering sheet extends beyond theperiphery of the wound care article and is attachable to the skinsurrounding the wound.
 51. The wound care article according to claim 45,characterized in that the covering sheet is 5% to 300% larger in surfacearea than the enclosing surface of the second enclosure.
 52. The woundcare article according to claim 45, characterized in that the coveringsheet is elastically and/or plastically stretchable and/or deformable,such that the respective maximum volume increase of the wound carearticle during the absorption process is fundamentally not inhibited.53. The wound care article according to claim 45, characterized in thatthe covering sheet is laid wrinkled and/or pleated and/or folded and/orbellows-shaped.
 54. The wound care article according to claim 1,characterized in that the second enclosure is 3% to 300% larger insurface area than the fluid-absorbing structure or the material layer.55. The wound care article according to claim 1, characterized in thatthe material layer is spirally shaped in top view of its flat side. 56.The wound care article according to claim 55, characterized in that thespiral-shaped material layer is manufactured by thermal and/ormechanical cutting or punching.
 57. The wound care article according toclaim 1, characterized in that the material layer in a top view of itsflat side comprises multiple, concentrically applied, round orrectangular frames.
 58. The wound care article according to any of thepreceding claim 1, characterized in that at least one cut is introducedon the enclosing surface of the second enclosure, and the material layerthat is spirally shaped or comprises multiple concentric frames at leastpartly extends out of the enclosing surface when applied on the wound.59. The wound care article according to claim 58, characterized in thatthe cuts are diagonally or radially arranged.
 60. The wound care articleaccording to claim 1, characterized in that in addition, the wound carearticle a. comprises at least one nutritious, at least one disinfectingor decontaminating, and/or at least one protease-limiting affectingactive substance and/or compound of active substances, b. comprises atleast one chemically, physiologically, and/or physically affectingactive substance or a compound of active substances, or such an agent,which can limit bleeding or the susceptibility to bleeding.
 61. Thewound care article according to claim 1, whereby substantial componentsof the article are substantially white or naturally coloured,characterized in that after application to the wound and directmoistening with the wound fluid, the wound care article marks therespective wound areas and the exterior contour of the wound in colourthrough the retention of the wound covering's originally-colouredsurface areas, whereby the wound covering reaches past the respectivewound edge in the applied condition of the absorbing structure, andcovers healthy skin areas all around the wound, and that the woundcovering changes in thickness in such a manner, in that the thicknessincreases proportionally corresponding to the local absorptionconditions, through osmotic or atmospheric pressure conditions; whereasthe original thickness of the pad remains unchanged for the mentionedadjoining surface areas.
 62. The use of a wound care article accordingto claim 1 for treatment of chronic wounds, acutely bleeding wounds, andtraumatically created wounds.
 63. The use of a wound care articleaccording to claim 1 for operative or post-operative supply or formilitary purposes.
 64. Kit for chronic supply, or the acute, emergency,or military medical care or chronic supply, comprising a wound carearticle according to claim 1.